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HomeMy WebLinkAboutOpening of Bids - Beacon Health New Parking Proj No 123-076A - Gibson-LewisCITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK Project Name Beacon Health Parking Lot, 530 N. Lafayette Blvd. South Bend, IN Project No. 123-076A For Bids Due 10 December 2024 PART I (Must be completed for all bids. Please type or print) Date: 12/10/24 Bidder (Firm): Gibson -Lewis, LLC Address: 1001 W. I Ith Street City/State/Zip: Mishawaka, IN 46544 Telephone Number: ( 574 ) 259-8581 Agent of Bidder (if Applicable): Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the public works project of: Beacon Health Parking Lot as described in the documents. the City of South Bend, Indiana, in accordance with plans and specifications prepared by: American Structurepoint, Inc. and dated 11/13/2024 for the sum of (enter the Total Bid as shown on the Proposal) (Enter sum of Total Base Bid plus Alternates shown on Proposal) (Numerical) The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the notice. Any addendums attached will be spec' ally referenced at the applicable page. If additional units of material included in the contract ar neede , the cos of units must be the same as that shown in the original contract if accepted by t e C y o� $ th n . the bid is to be awarded on a unit basis, the itemization of the units shall be sh n o as rate c ment. By `� 5i nature) ick G rbick, Vice P siI (Printed Name of Person Signing) ACCEPTANCE The above bid is accepted this day of 20 Subject to the following conditions: BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President Gary A. Gilot, Member Joseph R. Molnar, Vice President Briana N. Micov, Member Version 07/19/2023 Contractor's Bid for Public Works - 2 BID/PROPOSAL CITY OF SOUTH BEND Project Name: Beacon Health Parking Lot Project Number: 123-076A For Bids Due: 10 December 2024 Contractor Name: Gibson -Lewis, LLC BASE BID 07 J s Item No. Description Quantity Unit Unit Price Total Amount 1 Beacon Health Parking Lot as _ described in the documents. 1 LSUM BASE BID TOTAL UNIT PRICES The unit costs herein quoted are to apply to additions or deductions to the contract. The following Unit prices are for the cost of the material installed, unless noted otherwise. The unit prices shall Include all incidental items, such as use of tools, scaffolding, equipment, contractor's overhead and Profit, taxes, insurance, etc. All quantities will be determined by measurements in place. The right is reserved to reject any and all unit prices if the cost is considered excessive. Item DescriNo.ption Price Units Removal of Unsuitable Materials (as determined by testing 1 agency); which includes cost of excavation, loading, hauling $ Per CYS and offsite disposal Removal of Suitable Materials (as determined by testing 2 agency); which includes cost of excavation, loading, hauling $ Per CYS and offsite disposal Removal and haul off of existing HMA pavement; including 3 subbase $ Per CYS 4 Removal and haul off of existing concrete sidewalk; including $ Per subbase SF 5 Removal and haul off of existing concrete curb and gutter $ Per LF 6 Fuel Tank Removal and Disposal; includes concrete $ Per enclosure EA 7 Concrete ADA Ramp $ Per EA 8 Concrete Curb and Gutter $ Per LF 9 Concrete Sidewalk (includes aggregate subbase) $ Per SF Version 07/19/2023 Contractor's Bid for Public Works - 8 BID/PROPOSAL CITY OF SOUTH BEND Project Name: Beacon Health Parking Lot Project Number: 123-076A For Bids Due: 10 December 2024 Contractor Name: Gibson -Lewis, LLC 10 Concrete Pavement - Heavy Duty (includes aggregate subbase) $ Per SF 11 Concrete Pavement - Heavy Duty Decorative Stamped (includes aggregate subbase) $ Per TON 12 HMA Surface (9.5 mm) $ Per TON 13 HMA Intermediate Base (19.0 mm) $ Per TON 14 HMA Base (25.0 mm) $ Per TON 15 Compacted Aggregate, INDOT #53 Stone $ Per TON 16 Compacted Aggregate, INDOT #8 Stone $ Per TON 17 Compacted Aggregate, INDOT #2 Stone $ Per TON Bidder (Firm): Address: Gibson -Lewis, LLC 1001 W. I Ith Street City/State/Zip: Mishawaka, IN 46544 re) Nick Gurbick, Vice President (Printed Name of Person Signing) Version 07/19/2023 Contractor's Bid for Public Works - 9 When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, CERTIFICATION REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY VERIFICATION, NON- DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS OR FOUNDRY PRODUCTS (Must be completed for all quotes and bids. Please type or print) STATE OF INDIANA ) ) SS: ST JOSEPH COUNTY ) The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that: 1. Contractor has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person in reference to such bidding. Contractor further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and 2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency; and 3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in investment activities in Iran. a. For purposes of this Certification, "Iran" means the government of Iran and any agency or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as amended from time -to -time. b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor is engaged in investment activities in Iran if either: i. Contractor, its successor or its affiliate, provides goods or services of twenty million dollars ($20,000,000) or more in value in the energy sector of Iran; or ii. Contractor, its successor or its affiliate, is a financial institution that extends twenty million dollars ($20,000,000) or more in credit to another person for forty-five (45) days or more, if that person will (i) use the credit to provides goods and services in the energy sector in Iran; and (ii) at the time the financial institution extends credit, is a person identified on list published by the Indiana Department of Administration. 4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the Contractor subsequently learns is an unauthorized alien. Version 07/19/2023 Contractor's Bid for Public Works - 5 Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of Contractor's newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3. Contractor's documentation of enrollment and participation in the E-Verify Program is included and attached as part of this bid/quote; and 5. Contractor shall require his/her/its subcontractors performing work under this public contract to certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the subcontractor subsequently leams is an unauthorized alien, and that the subcontractor has enrolled in and is participating in the E-Verify Program. The Contractor agrees to maintain this certification throughout the term of the contract with the City of South Bend, and understands that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision no later than thirty (30) days after being notified by the City. 6. Persons, firms, partnerships, corporations, associations, or joint venturers awarded a contract by the City of South Bend through its agencies, boards, or commissions shall not discriminate against any employee or applicant for employment in the performance of a City contract with respect to hire, tenure, terms, conditions, or privileges of contract or employment, or any matter directly or indirectly related to contracting or employment because of race, sex, religion, color, national origin, ancestry, gender expression, gender identity, sexual orientation, or due to age or disability that does not affect that person's ability to perform the work. In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any combination of the foregoing including, but not limited to, public works contracts awarded under public bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards, or commissions will consider the Contractor's good faith efforts to obtain participation by those subcontractors certified by the State of Indiana as a Minority Business ("MBE") or as a Women's Business Enterprise ("WBE") as a factor in determining the lowest, responsible, responsive bidder. Contractors seeking the award of a City contract cannot be required to award a subcontract to an MWBE; however, they may not unlawfully discriminate against said MBE/WBE. On goal -eligible contracts, Contractors are required to either meet both MBE and WBE utilization goals or demonstrate that the Contractor has made good faith efforts to obtain participation from MBE and WBE subcontractors. A finding of noncompliance or a discriminatory practice shall prohibit that Contractor from being awarded a City contract for a period of one (1) year from the date of such determination, and such determination may also be grounds for terminating the contact to which the discriminatory practice or noncompliance pertains. 7. The undersigned Contractor agrees that the following nondiscrimination commitment shall be made a part of any contract which it may henceforth enter into with the City of South Bend, Indiana or any of its agencies, boards or commissions. Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the performance of this contract with privileges of employment, or any matter directly or indirectly related to employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of contract. I, the undersigned bidder or agent as contractor on a public works project, understand my statutory obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1). 1 hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to the City, subject to review and approval, why the cost of United States made steel or foundry products is unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a determination if the price of United States made steel or foundry is unreasonable. I understand that Version 07/19/2023 Contractor's Bid for Public Works - 6 violations hereunder may result in forfeiture of contractual payments. I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for public works are true and correct. Dated this 1 Oth A ay of Deceml�Q020?^ Subscribed and sworn to before me this My Commission Expires 08/05/2031 Nick Gurbick, Vice President Printed Name and Title of December 20 24 County of Residence St. Public ]uli Hodowaniec JLJL� H000wANiEC St Josef CounPublic - Sta Seal Comn1fssion Number NpO6j1289a MY Camn,fssion ExRfres Aug g, 2Q;1 Version 07/19/2023 Contractor's Bid for Public Works - 7 uluson-Lewis, LLL The undersigned hereby declares that the foregoing is a true statement of the financial condition of the individual, co -partnership, or corporation herein first named, as of the date herein first given; that this statement is for the express purpose of inducing the party to whom it is submitted to award the submitter a contract; and that any depository, vendor or other agency herein named is hereby authorized to supply such party with any information necessary to verify this statement. NOTE: A co -partnership must give firm name and signatures of all partners. A corporation must give full corporate name, signature of official and affix corporate seal. STATE OF COUNTY OF Affidavit for Individual ISS: being duly sworn, deposes and says that the foregoing financial statement, taken from his books, is a true and accurate statement of his financial condition as of the date thereof and that the answers to the foregoing interrogatories are true. Subscribed and sworn to before me this day of Notary Public Affidavit for Co -Partnership STATE OF COUNTY OF SS: (Applicant must sign here) being duly sworn, deposes and says that he is a member of the firm of . that he is familiar with the books of the said firm showing its financial condition; that the foregoing financial statement, taken from the books of said firm, is a true and accurate statement of the financial condition of the said firm as of the date thereof and that the answer to the foregoing interrogatories are true. Subscribed and sworn to before me this (Member of firm must sign here) day of Notary Public Affidavit for Corporation STATE of INDIANA COUNTY OF ST. 30SEPH SS: Nick Gurbock being duly sworn, deposes and says that he is Vice President of the Gibson -Lewis LL DMM * described in and which executed the foregoing statement; that he is familiar with the books of the sai orporatia sho in ' s financial condition; that the foregoing financial statement, taken from the books of the said corporation, is a true and accurn at?Mn ❑f the s d ial condition of said corporation as of the date thereof and that the answers to the foregoing interrogatories are true. mi d Lia Ity n Subscribed and sworn to before me this ffi x m t sign here) 1 Oth day of December ,0 24 Nick Gu Wck Vice r ident J IBWANIEC ry Public - Seal Notary Public Juii I {v�i un County -State of Indiana sston Number NP0671289 My Commission Expires: 8/05/2031 My Commission Expires Aug, 5, 2031 -14- Residing in St. Joseph County Document A310TM - 2010 Conforms with The American Institute of Architects AIA Document 310 CONTRACTOR: (Name, legal status and address) Gibson -Lewis, LLC 1001 West 11th Street Mishawaka, IN 46544 OWNER: (Name, legal status and address) City of South Bend, Indiana 227 West Jefferson Blvd. South Bend, IN 46601 Bond Number: 03992-CNA-24-175 SURETY: (Name, legal status and principal place of business) The Continental Insurance Company 151 N Franklin Street Chicago, IL 60606 State of Inc: Pennsylvania BOND AMOUNT: Five Percent of Amount Bid (5% of the Amount Bid) PROJECT: This document has important legal consequences. Consultation with an attorney is encouraged with respect to its completion or modification. Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. (Name, location or address, and Project number, if any) Beacon Health Parking Lot - 530 N. Lafayette Blvd. South Bend, IN - Project #123-076A The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof; or (2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the intent is that this Bond shall be construed as a statutory bond and nit as a common law bond. and sealed this 22nd day of Juli Hodowaniec November 2024 Ni (Surety) LLC Vice President Insurance Cornpan lannotta _— (Title) Kristin . Bender, Attorney -in -Fact (Seal) (Seal) POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT Know All Men By These Presents, That The Continental Insurance Company, a Pennsylvania insurance company, is a duly organized and existing insurance company haling its principal office in the City of Chicago, and State of Illinois, and that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint Kristin S. Bender , Individually of Morristown New Jersey : its true and lawful Attorney(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts - Surety Bond Number: _ 03992-CNA-24-175 Principal; Gibson -Lewis, LLC Obligee: City of South Bend Indiana and to bind them thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the insurance company and all the acts of said Attorney, pursuant to the authority hereby given is hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By -Laws and Resolutions, printed below, duly adopted, as indicated, by the Board of Directors of the insurance company. In Witness Whereof, The Continental Insurance Company has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 13th day of March, 2024. The Continental Insurance Company c Larry Kasten Vice President State of South Dakota, County of Minnehaha, ss: On this 13th day of March, 2024, before me personally came Larry Kasten to me known, who, being by me duly sworn, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is a Vice President of The Continental Insurance Company, a Pennsylvania insurance company, described in and which executed the above instrument; that he knows the seal of said insurance company; that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said insurance company and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said insurance company. SS M.BENT I, }�"gNOA{HY PUBLICS j i� SOk11'H PUM My Commission Expires March 2, 2026 M. Bent Notary Public CERTIFICATE I, Paula Kolsrud, Assistant Secretary of The Continental Insurance Company, a Pennsylvania insurance company, do hereby certify that the Power of Attorney herein above set forth is still in force, and further certify that the By -Laws and Resolutions of the Board of Directors of the insurance company printed below are still in force. In testimony whereof have hereunto subscribed my name and affixed the seal of the said insurance company this 22nd day of November 2024 :rCZ��hLtHBU,� . The Continental Insurance Company V) opj,�,nj Paula Kolsrud �A3sistant Secretary Authorizing By -Laws and Resolutions ADOPTED BY THE BOARD OF DIRECTORS OF THE CONTINENTAL INSURANCE COMPANY: This Power of Attorney is made and executed pursuant to and by authority ofthe following resolution duly adopted by the Board of Directors of the Company at a meeting held on May 10, 1995. "RESOLVED: That any Senior or Group Vice President may authorize an officer to sign specific documents, agreements and instruments on behalf of the Company provided that the name of such authorized officer and a description of the documents, agreements or instruments that such officer may sign will be provided in writing by the Senior or Group Vice President to the Secretary of the Company prior to such execution becoming effective." This Power of Attorney is signed by Larry Kasten, Vice President, who has been authorized pursuant to the above resolution to execute power of attorneys on behalf of The Continental Insurance Company. This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company by unanimous written consent dated the 251" day of April, 2012: "Whereas, the bylaws of the Company or specific resolution of the Board of Directors has authorized various officers (the "Authorized Officers") to execute various policies, bonds, undertakings and other obligatory instruments of like nature; and Whereas, from time to time, the signature of the Authorized Officers in addition to being provided in original, hard copy format, may be provided via facsimile or otherwise in an electronic format (collectively, "Electronic Signatures"); Now therefore be it resolved: that the Electronic Signature of any Authorized Officer shall be valid and binding on the Company." This Power of Attorney may be signed by digital signature and sealed by a digital or otherwise electronic -formatted corporate seal under and by the authority of the following Resolution adopted by the Board of Directors of the Company by unanimous written consent dated the 27th day of April, 2022: "RESOLVED: That it is in the best interest of the Company to periodically ratify and confirm any corporate documents signed by digital signatures and to ratify and confirm the use of a digital or otherwise electronic -formatted corporate seal, each to be considered the act and deed of the Company." Form F6850-2/2024 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE-1.0 ' MBE UTILIZATION PLAN This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MBE participation. It is the bidder's sole responsibility to verify whether any listed minority -owned business meets the MBE qualifications. ***Goals should be calculated based on the Base Bid only.*** Project Number: Bidder: 123-076A Project Name: Beacon Health Parking Lot, 530 N. Lafavette Blvd. South Bend, IN Gibson -Lewis, LLC Total Bid Amount: MBE Goal: 2.6% Page of Name & Address of MBE Primary Contact Person (Name/Telephone) Scope of Work to be Performed (Attach scope/schedule if you need additional space) Dollar Amount of MBE Component Percentage of Total Bid/Proposal Submitted by: Nick Gurbick, Vice President 12/10/24 Print Name ignat re Date ***Goals should be calculated based on the Base Bid only.*** This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving WBE participation. It Version 07/19/2023 Contractor's Bid for Public Works -10 CITY OF SOUTH BEND -_ J MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN = FORM WBE-1.0 WBE UTILIZATION PLAN is the bidder's sole responsibility to verify whether any listed woman -owned business meets the WBE qualifications. ***Goals should be calculated based on the Base Bid only.*** Project Number: Bidder: 123-076A Project Name: Beacon Health Parking Lot, 530 N. Lafayette Blvd. South Bend, IN Gibson -Lewis, LLC Total Bid Amount: WBE Goal: 5.1 % Page of Name & Address of WBE Primary Contact Person (Name/Telephone) Scope of Work to be Performed (Attach scope/schedule if you need additional space) Dollar Amount of WBE Component Percentage of Total Bid/Proposal All Lh Submitted by: Nick Gurbick, Vice President Print Name gignat re ***Goals should be calculated based on the Base Bid only.*** Version 07/19/2023 Contractor's Bid for Public Works - 11 12/10/24 Date ..}filf y�. Y CITY OF SOUTH BEND i MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE-2.0 n, EVIDENCE OF GOOD FAITH EFFORTS This completed form should be included as part of the Bids documents related to City of South Bend Public Works Projects requiring Good Faith Efforts to obtain MBE participation. Project Number: 123-076A Date: Project Name: Bidder: Contact Person: Address: Beacon Health Parking Lot,_ 530 N. Lafayette Blvd. South Bend, IN Gibson -Lewis, LLC Nick Gurbick, Vice President Telephone: 574-259-8581 1001 W. 11 th Street City: Mishawaka State: IN zip: 46544 Email: ngurbick(�gl.nceusa.com To determine whether a bidder has demonstrated good faith efforts to reach the MBE utilization goals set forth in the City of South Bend Public Works Project Specifications, the City and its agencies, boards, or commissions, REQUIRE ALL of the following Good Faith Efforts as listed in the table below*: EVIDENCE OF GOOD FAITH EFFORTS MBE LIST(S): The bidder reviewed 1) the City of South Bend's Minority and Women Business Enterprise Inclusion Program Plan; 2) the list of certified MWBEs provided by the City; and 3) the NG Indiana Department of Administration list of Minority and Women Owned Businesses (both certified and non -certified) found at: htt :/Iwww.in. ov/idoa/. GOOD FAITH EFFORTS TO OBTAIN MBE PARTICIPATION The bidder shall initial each item below, as evidence of its good faith efforts to obtain MBE participation in the awarded contract. I affirm that I reviewed the City of South Bend's Minority and Women Business Enterprise Inclusion Program Plan and the Indiana Department of Administration's NG certified list of Indiana Minority and Women Business Enterprises, found on their website (htip://www.in.gov/idoa). I affirm that I have made good faith efforts to select portions of the contract work to be NG performed by MWBEs, including, where appropriate, breaking out contract work items into economically feasible units to facilitate MBE participation. I affirm that I have made good faith efforts to solicit through all reasonable and available NG means the interest of all MBEs in the scopes of work of the contract. NG I affirm that I attended all pre -bid meetings scheduled by the City of South Bend to inform MBEs of contracting and subcontracting opportunities. I affirm that I advertised in general circulation and/or trade association publications NG concerning subcontract opportunities and allowed MBEs reasonable time to respond to such advertisements. I affirm that I performed any and all necessary steps to provide written notices in a NG manner reasonably calculated to inform MBEs of subcontracting opportunities and allowed sufficient time for MBEs to participate effectively. NG I affirm that I followed up on initial solicitations with interested MBEs. I affirm that I negotiated with interested MBEs in good faith, including providing such NG MBEs with adequate information about the plans, specifications and other requirements of the subcontract. I affirm that I have made good faith efforts to assist interested MBEs in obtaining NG bonding, lines of credit, or insurance as required by the City or the bidder, where appropriate. Version 07/19/2023 Contractor's Bid for Public Works - 12 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS I affirm that I have made good faith efforts to assist interested MBEs in obtaining NG necessary equipment, supplies, materials, or related assistances or services, where appropriate. NCi I affirm that I did not reject any MBEs as unqualified without sound business reasons based on a thorough investigation of their capabilities. CONTRACT RECORDS: The bidder has maintained the following records for each MBE that has bid on the subcontracting opportunity: 1. Name, address, and telephone number; 2. A description of information provided by the bidder or subcontractor; and 3. A statement of whether an agreement was reached, and if not, why not, including any reasons for concluding that the MBE was unqualified to perform the job. *Proper demonstration of Good Faith Efforts requires your initials next to all of the above boxes. Any omissions shall be considered grounds for rejection of the bid by the Board of Public Works. The City of South Bend reserves the right to request additional information. Version 07/19/2023 Contractor's Bid for Public Works - 13 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLANY'-, FORM MBE-2.1 MBE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring Good Faith Efforts to contact MBEs. It is the bidder's sole responsibility to verify whether any listed minority -owned business meets the MBE qualifications. Attach additional pages if necessary. PAGE OF Project Numb 123 QA MBE Participation Goal 2.6% Project Na e: f eaco alth Parking Lot, 530 N. Lafayette Blvd. South Bend IN Bidder: Gi n- ewis, LL By: Vice President 12/10/24 ignat re) ick Gi bick (Title) (Date) MBE Firm Owner or Contact at MBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE MBE FIRM: MBE Firm Owner or Contact at MBE Firm Telephone Fax: Email TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE MBE FIRM: Version 07/19/2023 Contractor's Bid for Public Works - 16 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLANY'-, FORM MBE-2.1 MBE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring Good Faith Efforts to contact MBEs. It is the bidder's sole responsibility to verify whether any listed minority -owned business meets the MBE qualifications. Attach additional pages if necessary. PAGE OF Project Numb 123 QA MBE Participation Goal 2.6% Project Na e: f eaco alth Parking Lot, 530 N. Lafayette Blvd. South Bend IN Bidder: Gi n- ewis, LL By: Vice President 12/10/24 ignat re) ick Gi bick (Title) (Date) MBE Firm Owner or Contact at MBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE MBE FIRM: MBE Firm Owner or Contact at MBE Firm Telephone Fax: Email TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE MBE FIRM: Version 07/19/2023 Contractor's Bid for Public Works - 16 CITY OF SOUTH BEND n MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE-2.1 WBE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring Good Faith Efforts to contact WBEs. It is the bidder's sole responsibility to verify whether any listed woman -owned business meets the WBE qualifications. Attach additional pages if necessary. PAGE OF Project Number: 123-07fiA d WBE Participation Goal 5.1 % Project NaB can H th Parkin Lot 530 N. Lafayette Blvd. South Bend, IN 7//"hbs Bidder: - wis. LLC By: Vice President 12/10/24 ( gnatu a {;'rk (Title) (Date) WBE Firm Owner or Contact at WBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE WBE FIRM: WBE Firm Owner or Contact at WBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE WBE FIRM: Version 07/19/2023 Contractor's Bid for Public Works - 17 CITY OF SOUTH BEND n MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE-2.1 WBE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring Good Faith Efforts to contact WBEs. It is the bidder's sole responsibility to verify whether any listed woman -owned business meets the WBE qualifications. Attach additional pages if necessary. PAGE OF Project Number: 123-07fiA d WBE Participation Goal 5.1 % Project NaB can H th Parkin Lot 530 N. Lafayette Blvd. South Bend, IN 7//"hbs Bidder: - wis. LLC By: Vice President 12/10/24 ( gnatu a {;'rk (Title) (Date) WBE Firm Owner or Contact at WBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE WBE FIRM: WBE Firm Owner or Contact at WBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE WBE FIRM: Version 07/19/2023 Contractor's Bid for Public Works - 17 CITY OF SOUTH BEND n MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE-2.1 WBE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring Good Faith Efforts to contact WBEs. It is the bidder's sole responsibility to verify whether any listed woman -owned business meets the WBE qualifications. Attach additional pages if necessary. PAGE OF Project Number: 123-07fiA d WBE Participation Goal 5.1 % Project NaB can H th Parkin Lot 530 N. Lafayette Blvd. South Bend, IN 7//"hbs Bidder: - wis. LLC By: Vice President 12/10/24 ( gnatu a {;'rk (Title) (Date) WBE Firm Owner or Contact at WBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE WBE FIRM: WBE Firm Owner or Contact at WBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE WBE FIRM: Version 07/19/2023 Contractor's Bid for Public Works - 17 CITY OF SOUTH BEND n MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MBE-2.1 WBE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring Good Faith Efforts to contact WBEs. It is the bidder's sole responsibility to verify whether any listed woman -owned business meets the WBE qualifications. Attach additional pages if necessary. PAGE OF Project Number: 123-07fiA d WBE Participation Goal 5.1 % Project NaB can H th Parkin Lot 530 N. Lafayette Blvd. South Bend, IN 7//"hbs Bidder: - wis. LLC By: Vice President 12/10/24 ( gnatu a {;'rk (Title) (Date) WBE Firm Owner or Contact at WBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE WBE FIRM: WBE Firm Owner or Contact at WBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE WBE FIRM: Version 07/19/2023 Contractor's Bid for Public Works - 17 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM WBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS This completed form should be included as part of the Bids documents related to City of South Bend Public Works Projects requiring Good Faith Efforts to obtain MWBE participation. Project Number: 123-076A Date: 12/10/24 Project Name: Beacon Health Parking Lot, 530 N. Lafayette Blvd. South Bend, IN Bidder: Gibson -Lewis, LLC Contact Person: Nick Gurbick, Vice President Telephone: 574-259-8581 Address: 1001 W. 1 Ith Street City: Mishawaka State: Indiana Zip: 46544 Email: n urbick[rr�,g1mccusa.com To determine whether a bidder has demonstrated good faith efforts to reach the WBE utilization goals set forth in the City of South Bend Public Works Project Specifications, the City and its agencies, boards, or commissions, REQUIRE ALL of the following Good Faith Efforts as listed in the table below": EVIDENCE OF GOOD FAITH EFFORTS WBE LIST(S): The bidder reviewed 1) the City of South Bend's Minority and Women Business Enterprise Inclusion Program Plan; 2) the list of certified MWBEs provided by the City; and 3) the NG Indiana Department of Administration list of Minority and Women Owned Businesses (both certified and non -certified) found at: http://www.in.qov/idoa/. GOOD FAITH EFFORTS TO OBTAIN WBE PARTICIPATION The bidder shall initial each item below, as evidence of its good faith efforts to obtain WBE participation in the awarded contract. I affirm that I reviewed the City of South Bend's Minority and Women Business Enterprise Inclusion Program Plan and the Indiana Department of Administration's NG certified list of Indiana Minority and Women Business Enterprises, found on their website (http://www.in.gov/idoa). I affirm that I have made good faith efforts to select portions of the contract work to be NG performed by WBEs, including, where appropriate, breaking out contract work items into economically feasible units to facilitate WBE participation. I affirm that I have made good faith efforts to solicit through all reasonable and available NG means the interest of all WBEs in the scopes of work of the contract. NG I affirm that I attended all pre -bid meetings scheduled by the City of South Bend to inform WBEs of contracting and subcontracting opportunities. I affirm that I advertised in general circulation and/or trade association publications NG concerning subcontract opportunities and allowed WBEs reasonable time to respond to such advertisements. I affirm that I performed any and all necessary steps to provide written notices in a NG manner reasonably calculated to inform WBEs of subcontracting opportunities and allowed sufficient time for WBEs to participate effectively. NG I affirm that I followed up on initial solicitations with interested WBEs- I affirm that I negotiated with interested WBEs in good faith, including providing such NG WBEs with adequate information about the plans, specifications and other requirements of the subcontract. I affirm that I have made good faith efforts to assist interested WBEs in obtaining NG bonding, lines of credit, or insurance as required by the City or the bidder, where appropriate. Version 07/19/2023 Contractor's Bid for Public Works - 14 CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM WBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS i affirm that I have made good faith efforts to assist interested WBEs in obtaining NG necessary equipment, supplies, materials, or related assistances or services, where appropriate. N� I affirm that I did not reject any WBEs as unqualified without sound business reasons based on a thorough investigation of their capabilities. CONTRACT RECORDS: The bidder has maintained the following records for each WBE that has bid on the subcontracting opportunity: 1. Name, address, and telephone number; 2. A description of information provided by the bidder or subcontractor; and 3. A statement of whether an agreement was reached, and if not, why not, including any reasons for concluding that the MWBE was unqualified to perform the job. *Proper demonstration of Good Faith Efforts requires your initials next to all of the above boxes. Any omissions shall be considered grounds for rejection of the bid by the Board of Public Works. The City of South Bend reserves the right to request additional information. Version 07/19/2023 Contractor's Bid for Public Works - 15 PART II (For projects of $100,000 or more — IC 36-1-12-4) These statements to be submitted under oath by each bidder with and as part of his/her/its bid. Attach additional pages for each section as needed. SECTION I EXPERIENCE QUESTIONNAIRE 1. Attach information regarding projects your organization has completed for the period of one (1) year prior to the date of the current bid. 2. Attach a listing of public works projects currently in process of construction by your organization. 3. Attach information regarding any failure to complete any work awarded to you and the location thereof. 4. Attach references from private firms for which you have performed work. SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE 1. Attach an explanation of your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, complete the project, number of workers, etc. and any other information which you believe would enable the City of South Bend to consider your bid.) 2. Attach a listing of the names and addresses of all subcontractors (i.e. persons or firms outside your own firm who have performed part of the work) that you have used on public works projects during the past five (5) years along with a brief description of the work done by each subcontractor. 3. If you intend to sublet any portion of the work, attach the name and address of each subcontractor, equipment to be used by the subcontractor, and whether you will require a bond. However, if you are unable to currently provide a listing, please understand a listing must be provided prior to contract approval. Until the completion of the proposed project, you are under a continuing obligation to immediately notify the City of South Bend in the event that you subsequently determine that you will use a subcontractor on the proposed project. 4. Attach a listing of equipment you have available to use for the proposed project. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? If not, attach an explanation for the rationale used which would corroborate the prices listed. SECTION III CONTRACTOR'S FINANCIAL STATEMENT Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial *See attached Financial Statement Version 07/19/2023 Contractor's Bid for Public Works - 3 statement provided hereunder to the City of South Bend awarding the contract must be specific enough in detail so that said City of South Bend can make a proper determination of the bidder's capability for completing the project if awarded. Version 07/19/2023 Contractor's Bid for Public Works - 4 131dder: Uibson-Lewis, LLU 3. Have you ever failed to complete any work awarded to you? No If so, where and why? 4. List references from private firms for which you have performed work. University of Notre Dame - Notre Dame, Indiana Memorial Hospital of South Bend - South Bend, Indiana 1st Source Bank - South Bend, Indiana SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE 1. Explain your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, complete the project, number of workers, etc. and any other information which you believe would enable the governmental unit to consider your bid.) Apply adequate personnel to complete the work 2. Please list the names and addresses of all subcontractors (i.e. persons or firms outside your own firm who have performed part of the work) that you have used on public works projects during the past five (5) years along with a brief description of the work done by each subcontractor. Please see attached listing CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK CHECKLIST FOR BIDDERS Project Name Beacon Health Parking Lot, 530 N. Lafayette Blvd. South Bend, IN Project No. 123-076A For Bids Due 10 December 2024 From time to time the South Bend Board of Public Works finds it necessary to reject a bid because it does not comply with statutory requirements. In preparing your bid, please use the following checklist in order to make sure that your bid is done in the proper manner. X Proper bid security included. The bidder has the option of providing either a Certified Check or Bid Bond. Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely X executed. Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and X Certification of use of United States Steel Products or Foundry Products. Proof of M/WBE Utilization Plans [MBE-1.0 and WBE-1.0]. Also provide Evidence of Good Faith Efforts Forms [MBE-2.0 and WBE-2.0] and M/WBE Contacted Forms [MBE-2.1 and X WBE-2.1]. X Acknowledge Receipt of Addendum(s) included with the bid. X All required additional information is included with the bid. X Proposal statements and other affidavits all signed by the proper party with name either X printed or typed underneath signature. X This checklist submitted with the Bid. This checklist is provided for bidder's use in assuring compliance with required documentation; however, it does not include all specifications requirements and does not relieve the bidder of the need t"ead arpdT9mply))0ith the specifications. Bidder: Gibson -Lewis, LW/ / 1 // Date: 12/10/24 By Authorized Represe Signature: Print Name & Title: Nick Gurbick, Vice Nesident Version 07/19/2023 Contractor's Bid for Public Works - 1 1316 COUNTY -CITY BUILDING 227 W.JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1 830 PHONE 574/235-9251 FAX 574/235-9171 TDD 574/ 235-5567 CITY OF SOUTH BEND, .TAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS Date: December 6, 2024 To: All Planholders From Theresa Heffner, Clerk, Board of Public Works Subject Addendum Number: 1 Project Name: Beacon Health Parking Lot Project Number: 123-076A ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUM Date Received: 12/6/24 This addendum is being forwarded to you for the above referenced project. Please sign below and acknowledge receipt of this Addendum by including with your electronic bid submission. THIS ADDENDUM MAY AFFECT YOUR BID. Notes: The attached documents are hereby added to the Specifications and Contract Documents and become a part of herein. i Company: Gibson Authorized Signature: ick Gu3 fck�ce Date: 12/6/24 Version 8/1 1/2020 KMFI-ijL,, SELECTED SUBS FOR FORM 96 INDIANA EARTH EXCAVATING RITSCHARD BROS., INC. 10343 MCKINLEY HWY. 1204 W SAMPLE STREET OSCEOLA, IN 46561 SOUTH BEND, IN 46619 WALSH & KELLY PAVING RIETH RILEY CONSTRUCTION 24358 STATE ROAD 23 25200 STATE ROAD 23 SOUTH BEND, IN 46614 SOUTH BEND, IN 46614 ZIOLKOWSKI CONSTRUCTION MASONRY KWIATKOWSKI MASONRY 1005 S LAFAYETTE STREET 1006 N INDIANA AVENUE SOUTH BEND, IN 46601 CROWN POINT, IN 46307 STEVENS IRON WORKS, INC STRUCTURAL STEEL CRANE INDUSTRIAL SERVICES P.O. BOX 730 11035 ANDERSON ROAD DEMOTTE, IN 46310 GRANGER, IN 46530 MIDLAND ENGINEERING ROOFING DUDECK ROOFING & SHEET METAL 52369 STATE HWY 933 1634 SOUTH FRANKLIN STREET SOUTH BEND, IN 46637 SOUTH BEND, IN 46614 WERNTZ SUPPLY GLASS & GLAZING PRECISION WALL 1002 KERR STREET 3801 S MAIN STREET SOUTH BEND, IN 46601 SOUTH BEND, IN 46614 OVERHEAD DOOR COMPANY OVERHEAD DOOR INDUSTRIAL DOOR OF NORTHERN IN P.O. BOX 907 3839 S. MAIN STREET MISHAWAKA, IN 46546 SOUTH BEND, IN 46614 MIDWEST TILE & INTERIORS INC FLOORING INTERIOR FINISHES, INC. 1805 N CEDAR ST 1616 W THIRD STREET MISHAWAKA, IN 46545 OSCEOLA, IN 46561 SHAMBAUGH & SON FIRE PROTECTION RYAN FIRE PROTECTION 7614 OPPORTUNITY DR 9740 EAST 148TH STREET FORT WAYNE, IN 46825 NOBLESVILLE, IN 46060 DA DODD, INC PLUMBING & HVAC EDWARD J WHITE P.O. BOX 430 1011 S. MICHIGAN STREET ROLLING PRAIRIE, IN 46371 SOUTH BEND, IN 46601 MARTELL ELECTRIC ELECTRIC KOONTZ WAGNER SERVICES 4601 CLEVELAND ROAD 3801 VOORDE DR SUITE B SOUTH BEND, IN 46628 SOUTH BEND, IN 46628 Bidder: Gibson -Lewis, LLC 3. If you intend to sublet any portion of the work, state the name and address of each subcontractor, equipment to be used by the subcontractor, and whether you will require a bond. However, if you are unable to currently provide a listing, please understand a listing must be provided prior to contract approval. Until the completion of the proposed project, you are under a continuing obligation to immediately notify the governmental unit in the event that you subsequently determine that you will use a subcontractor on the proposed project. Unresolved 4. What equipment do you have available to use for the proposed project? Any equipment to be used by subcontractors may also be required to be listed by the governmental unit. All necessary 5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? If not, please explain the rationale used which would corroborate the prices listed. No SECTION III CONTRACTOR'S FINANCIAL STATEMENT Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to the governing body awarding the contract must be specific enough in detail so that said governing body can make a proper determination of the bidder's capability for completing the project if awarded. *See attached Financial Statement Timestamp-Beacon Lot Company Name Dec 4, 2024 at 2:38 PM EST Ritschard Bros., Inc. Don Ritschard Dec 4, 2024 at 3:17 PM EST D&M Excavating Inc. Dec 4, 2024 at3:17 PM EST D&M Excavating Inc. Ryan Miller Dec 4, 2024 at 3:18 PM EST Michiana Concrete & Excavation LLC Devin Rudloff Dec 4, 2024 at 3:19 PM EST AlphaJak LLC Andre Jackson Dec 4, 2024 at 3:19 PM EST Fox Contractors Corp. Dallas D. Dec 4, 2024 at 3:19 PM EST Fox Contractors Corp. Nik Knobtauch Dec 4, 2024 at 3:20 PM EST Hubinger Landscaping Corporation david hubinger Dec 4, 2024 at 3:20 PM EST Hubinger Landscaping Corporation Lorraine Keilman Dec 4, 2024 at 3:20 PM EST Modern Edge joe drwaI Dec 4, 2024 at 3:20 PM EST Modern Edge Drew Sarkisian Dec 4, 2024 at 3:20 PM EST Tobin Landscape, Inc. Dan Tobin Dec 4, 2024 at 3:20 PM EST Tobin Landscape, Inc. Sherry Barrick Dec 4, 2024 at 3:20 PM EST Michiana Concrete & Excavation LLC Devin Rudloff Dec 4, 2024 at 3:21 PM EST The Great American Landscape Leonard Rompca Dec 5, 2024 at 4:10 PM EST Doug & Steve Construction Inc. Steve Sammons Dec 5, 2024 at 4:10 PM EST Doug & Steve Construction Inc. Debbie Trevino Dec 5, 2024 at 4:10 PM EST Circle City Rebar, LLC Michael Moyer Dec 5, 2024 at 4:10 PM EST Circle City Rebar, LLC Bryce Williams Email Phone Enterprise Type Bid Package ritl204@datacruz.com +1574.2BB-4777 Women Business Enterprise (WBE), Disadvantaged Business Enterprise (DBE) Earthwork chelsea@dandmexcavating.com +1219-872-9378 Women Business Enterprise (WBE) Earthwork ryan@dandmexcavating.com +1219-874-2882 Women Business Enterprise (WBE) Earthwork devin@michianamowsnow.com +1574-370-8088 Small Business Enterprise (SBE), Women Business Enterprise (WBE) Earthwork ajackson@alphajak.com +1574-800-4810 a Minority Business Enterprise (MBE), Disadvantaged Business Enterprise (DBE) Asphalt dday@foxcontractors.com (260) 747.7461 Minority Business Enterprise (MBE) Asphalt nknoblauch@foxcontractors.com +1260-755-7914 Minority Business Enterprise (MBE) Asphalt david@hubingers.com +1219-662-9911 Women Business Enterprise (WBE) Landscape Lorraine@hubingers.com +1219-662-9911 Women Business Enterprise (WBE) Landscape joedrwal@hotmail.com +1219-869-5782 Women Business Enterprise (WBE) Landscape dsarkisian@modernedgellc.com +1866-504-3343 Women Business Enterprise (WBE) Landscape dtobin@tobinlandscape.com +1269-262-0257 Minority Business Enterprise (MBE) Landscape sbarrick@tobinlandscape.com +1269-262-0257 Minority Business Enterprise (MBE) Landscape devin@michianamowsnow.com +1574-370-8088 Small Business Enterprise (SBE), Women Business Enterprise (WBE) Landscape thegreatamericanlandscape@msn.com +1219-322-7033 Women Business Enterprise (WBE), Disadvantaged Business Enterprise (DBE) Landscape ssammons@dands-const.com +1219-322-9112 Women Business Enterprise (WBE), Disadvantaged Business Enterprise (DBE) Concrete dtrevino@dands-const.com +1219-322-9112 Women Business Enterprise (WBE), Disadvantaged Business Enterprise (DBE) Concrete mmoyer@circlecityrebar.com +1317-727-7279 Minority Business Enterprise (MBE), Small Business Enterprise (SBE), Disadvantaged Business Enterprise Concrete bwilliams@circlecityrebar.com +1317-917-8566 Minority Business Enterprise (MBE), Small Business Enterprise (SBE), Disadvantaged Business Enterprise Concrete Communicath Bidding Status Bid Invite BIDDING Bid Invite UNDECIDED Bid Invite UNDECIDED Bid Invite UNDECIDED Bid Invite BIDDING Bid Invite UNDECIDED Bid Invite UNDECIDED Bid Invite UNDECIDED Bid Invite UNDECIDED Bid Invite UNDECIDED Bid Invite UNDECIDED Bid Invite UNDECIDED Bid Invite UNDECIDED Bid Invite UNDECIDED Bid Invite UNDECIDED Bid Invite UNDECIDED Bid Invite UNDECIDED Bid Invite NOT -BIDDING Bid Invite NOT -BIDDING EQUAL EMPLOYMENT OPPORTUNITY POLICY GIBSON-LEWIS, LLC has adopted the following policy on equal employment opportunity: The Company will not discriminate against any employee or applicant for employment because of race, color, religion, sex, age, national origin, disability, citizenship status, genetic information, ancestry, off -duty tobacco use, sealed or expunged arrest or conviction record and veteran status or any other basis protected by state, federal or other applicable law. The company is also committed not to discriminate regarding the following: ■ Referral, Hiring, Placement, Upgrading, Promotion, Transfer, Demotion, or Award of Tenure: • Recruitment, Advertising, Solicitation for Employment, or Job Application Procedures; • Rates of Pay or other Forms of Compensation and Changes in Compensation; • Treatment during Employment; • Job Assignments, Job Classifications, Organizational Structures, Position Descriptions, Lines of Progression, and Seniority Lists; • Leaves of Absence, Sick Leave, or any other Leave; • Fringe Benefits Available by Virtue of Employment, Whether or Not Administered by the Company; • Activities Sponsored by the Company including Social or Recreational Programs; • Selection and Financial Support for Training including Apprenticeship, Professional Meetings, Conferences, and other Related Activities and Selection for Leave of Absence to Pursue Training; Layoff or Termination; Right to Return from Layoff, Rehire, and all other Terms and Conditions of Employment The Company further agrees to provide a reasonable accommodation to any otherwise qualified individual with a disability unless the accommodation would cause an undue hardship, as and to the extent required by the Americans with Disabilities Act. The Company also seeks and intends to achieve and maintain full compliance with all other applicable statutes, regulations and executive orders on equal employment opportunity. THE COMPANY EXPECTS ALL EMPLOYEES TO ABIDE BY THIS POLICY. CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK RESPONSIBLE BIDDER CHECKLIST Project Name Beacon Health Parking Lot Project No. 123-076A For Bids Due Tuesday, December 10, 2024 @ 9:00 A.M. (E.S.T.) Contractor Name: Gibson -Lewis, LLC The City seeks to enhance its ability to identify responsive and responsible bidders on all City public works projects by institution of comprehensive submission requirements in compliance with State law. Quality workmanship, efficient operation, safety, and timely completion of projects requires that all bidders meet certain minimum requirements to be responsive and responsible bidders. THIS FORM MUST BE SUBMITTED WITH YOUR BID. **THIS FORM ONLY APPLIES TO BIDS GREATER THAN $250,000. ** INSTRUCTIONS: If you are a pre -qualified bidder, complete Section I only. If you are not a pre -qualified bidder, complete Section II only. Section II acts as an application for pre -qualification. Submission of Section II will allow the bidder to be considered for pre -qualification for bids with the City of South Bend Department of Public Works. Pre - qualified bidders will then be exempt from a portion of the submission requirements outlined in Section 6- 71 of The Responsible Bidding Ordinance No. 10975-23 (hereinafter, "Responsible Bidding Ordinance") for a period of twelve (12) months. Thereafter, contractors who are pre -qualified must submit a complete application for continuation of "pre - qualified" standing, on a form provided by the City ("Responsible Bidder Checklist (1) Pre -Qualified Bidders") within twelve (12) months of obtaining pre -qualified standing. If the status of any item changes within the twelve (12) months, it is the responsibility of the contractor to notify the City. Failure by any pre - qualified contractor to submit its complete application for continuation of "pre -qualified" standing within the time prescribed above shall result in automatic removal of the designation, effective immediately following the twelve (12) months of pre -qualified standing. However, the "removed" contractor or subcontractor shall still be permitted to bid on City public works projects, though the contractor must submit all required documents under 6-71 until "pre -qualified" status is re-established. Please Note: The City reserves the right to request supplemental information from the bidder, additional verification of any information provided by the bidder, and may also conduct random inquiries of the bidder's current and previous customers regardless of pre -qualified standing. It is the sole responsibility of the potential bidder to comply with all submission requirements applicable to the bidder in Section 6-71 of the Responsible Bidding Ordinance no later than the date of the public bid opening. Version 5/20/2024 General Conditions - 11 POST BID SUBMISSIONS: Post -bid submissions must be submitted in accordance with Section 6-72 of the Responsible Bidding Ordinance. The post -bid submission requirements are as follows: 1. All bidders shall collect, maintain, and provide upon request, a current written list that discloses the name, address, licensing status, and type of work for any subcontractor from whom the bidder has accepted a bid and/or intends to hire on any part of the public work project, including individuals performing work as independent contractors. 2. Each subcontractor, whose portion of the project is estimated to be at least two -hundred fifty thousand dollars ($250,000.00), shall be required to adhere to the requirements of Section I of the Responsible Bidder Ordinance as though it were bidding directly to the City, except that the subcontractor shall submit the required information (including the name, address, and type of work) to the successful bidder prior to the commencement of work. 3. Failure of a subcontractor to submit the required information shall not disqualify the successful bidder from performing work on the project and shall not constitute a contractual default and/or breach by the successful bidder. However, the City may withhold all payment otherwise due for work performed by a subcontractor, until the subcontractor submits the required information and the City approves such information. 4. The disclosure of a subcontractor list ("Disclosed Subcontractor(s)") to the City by a bidder shall not create any rights in the Disclosed Subcontractor(s). Thus, a bidder may substitute another subcontractor for a Disclosed Subcontractor by giving the City, upon request, written notice of the name, address, licensing status, and type of work of the substitute subcontractor. 5. The successful bidder for projects greater than $250,000 and all subcontractors performing work greater than $250,000 on a public works project are required to submit certified payroll utilizing the federal form known as WH-347 or a similar form on a bi-weekly basis, submitted within 10 days after the end of each bi-weekly payroll period. Certified payrolls shall identify the job title and craft for each employee. Certified payrolls shall be submitted electronically. Please Note: Submissions deemed inadequate, incomplete, or untimely by the City may result in the automatic disqualification of the bid. The City, after review of complete and timely submissions, shall, in its sole discretion, after taking into account all information in the submission requirements, determine whether a bidder is responsive and responsible, and provide a Pre -Qualification Verification Letter. The City specifically reserves the right to utilize all information provided in the contractor's submission and any information obtained by the City through its own independent verification of the information provided by the contractor. Version 5/20/2024 General Conditions - 12 PRE -QUALIFIED BIDDER CHECKLIST (a) Acknowledgements: (i) X By checking this box, I hereby acknowledge that I am a pre -qualified bidder with the City of South Bend and that I have met the pre -qualification requirements within the last twelve (12) months. A copy of my Pre -Qualification verification letter is attached. (ii) X By checking this box, I hereby acknowledge that the City reserves the right to request supplemental information, additional verification of any information provided by me, and may also conduct random inquiries of my current and prior customers. (iii) X By checking this box, I hereby acknowledge that apprenticeship and training programs that I participate in have graduated at least five (5) apprentices in each of the past five (5) years. (iv) X By checking this box, I hereby acknowledge that all subcontractors performing work greater than $250,000 also meet the qualifications of the Responsible Bidder Ordinance. (b) Attachments: (i) X Indiana Secretary of State's on-line records (ie. Business verification) dated within sixty (60) days of the submission of said document showing that business is in existence, current with the Indiana Secretary of State's Business Entity Report, and eligible for a certificate of good standing. (Not applicable to individuals, sole proprietors or partnerships). (ii) X Statement on staffing capabilities, including labor sources. This statement indicates and ensures I have sufficient employees on staff to complete the work. It outlines how I intend to meet the staffing needs of the work. (iii) X List of projects of similar size and scope of work performed in all areas, including the State of Indiana, within the last three (3) years. (iv) X For every project, submit evidence of participation in apprenticeship and training programs, applicable to the work to be performed on the project, which are approved by and registered with the United States Department of Labor's Office of Apprenticeship, or its successor organization. This includes, but may not be limited to, letters from apprenticeship coordinators detailing the bidder's association with the program, and the United States Department of Labor Office of Apprenticeship Certificates of Registration of Apprenticeship Programs for each type of work to be performed on the project. (ii) Gibson -Lewis, LLC will provide qualified leadership and tradesman from a pool of experienced employees to meet the requirements of the project. Long standing relationship with various craftsman unions including carpenters, Iaborers, cement masons, plasterers, and painters. Version 5/20/2024 General Conditions - 13 PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED) (a) Acknowledgements: (i) _ By checking this box, I hereby acknowledge that I am not a pre -qualified bidder with the City of South Bend. (ii) _ By checking this box, I hereby acknowledge that the City reserves the right to request supplemental information, additional verification of any information provided, and may also conduct random inquiries of my current and prior customers. The City reserved the right to utilize all information provided in this submission and all information obtained in inquiries or requests to determine if a bidder is responsive and responsible. Additionally, I acknowledge that all information provided to the City shall be regarded as public records. (iii) _ By checking this box, I hereby acknowledge that copies of all Applicable apprenticeship certificates or standards for training programs applicable to the work performed on the project may be requested at any time and shall be furnished upon request. (iv) _ By checking this box, I hereby acknowledge and ensure that I and all sub- contractors, from whom I have accepted a bid and/or intend to hire to perform work on the public work project, are properly licensed. Furthermore, I acknowledge my understanding that it is my responsibility to ensure that all sub -contractors have the necessary licenses to undertake the work called for in this bid. If a sub- contractor loses their license at any point, it is the responsibility of that sub- contractor to notify the City. (v) _ By checking this box, I hereby acknowledge that apprenticeship and training programs that I participate in have graduated at least five (5) apprentices in each of the past five (5) years. (vi) _ By checking this box, I hereby acknowledge that all subcontractors performing work greater than $250,000 also meet the qualifications of the Responsible Bidder Ordinance. (b) Attachments: (i) _ Indiana Secretary of State's on-line records (ie. Business verification) dated within sixty (60) days of the submission of said document showing that business is in existence, current with the Indiana Secretary of State's Business Entity Report, and eligible for a certificate of good standing. (Not applicable to individuals, sole proprietors or partnerships). List identifying all former business names. Any determinations by a court or governmental agency any violations of federal state, or local laws including, but not limited to, violations of contracting or antitrust laws, tax or licensing laws, environmental laws, Occupational Safety and Health Act (OSHA), or federal Davis -Bacon and related Acts, within the preceding five (5) years. (iv) Statement about staffing capabilities, including labor sources. This statement indicates and ensures I have sufficient employees on staff to complete the work I am bidding on OR outlines how I intend to meet the staffing needs of the work. (v) Statement that individuals who will perform work on the public work project on my behalf will be properly classified as an employee or as an independent contractor under all applicable state and federal laws and local ordinances. (v) For every project, submit evidence of participation in apprenticeship and training programs, applicable to the work to be performed on the project, which are approved by and registered with the United States Department of Labor's Office of Apprenticeship, or its successor organization. This includes, but may not be limited to, letters from apprenticeship coordinators detailing the bidder's association with Version 5/20/2024 General Conditions - 14 the program, and the United States Department of Labor Office of Apprenticeship Certificates of Registration of Apprenticeship Programs for each type of work to be performed on the project. (vi) _ _ Copy of a written plan for employee drug testing that covers all of my employees who will perform work on the public work project and meets or exceeds the requirements set forth in IC 4-13-18-5 or IC 4-13-18-6. (vii) Evidence that I am utilizing a surety company which is on the Bureau of Fiscal Service "Department of Treasury's Listing of Approved Sureties" as required in the bid specifications or contract. (viii) Written statement of any federal, state or local tax liens or tax delinquencies owed to any federal, state or local taxing body in the preceding three years. (ix) List of projects of similar size and scope of work performed in all areas, including the State of Indiana, within three (3) years prior to the date on which the bid is due. Nick Gurbick, Vice President (Print Name Here) Gibson -Lewis, LLC (Name of Company) 1001 W. 1 Ith Street (Address of Company) Mishawaka (City) Indiana (State) 574-259-8581 (Telephone Number) Version 5/20/2024 General Conditions - 15 CITY OF SOUTH BEND JAMES MUELLER, MAYOR DEPARTMENT OF PUBLIC WORKS ERIC HORVATH, DIRECTOR September 11, 2024 Juli Hodowaniec Gibson Lewis, LLC JHodowaniec@gl.nceusa.com RE: Pre -Qualification Verification Dear Ms. Hodowaniec: This letter serves as verification of Pre -Qualification status of your company for bidding with the City of South Bend. This Pre -Qualification status is effective for twelve (12) months from the date of this letter. Thereafter you are required to re -submit a complete application for continuation of pre -qualification status within twelve (12) months from the date of this letter. A copy of this Verification Letter must be included with every bid exceeding $250,000 submitted to the City of South Bend Board of Public Works, along with your Pre -Qualified Bidder Checklist and attachments. If you have any further questions regarding this matter, please call this office at (574) 235- 9251. Sincerely, Tara Bussell, Permit Manager BUSINESS INFORMATION DIEGO MORALES INDIANA SECRETARY OF STATE 10/21/2024 03:24 PM Business Details Business Name: GIBSON-LEWIS, LLC Business ID: 1995051381 Entity Type: Domestic Limited Liability Company Creation Date: 05/24/1995 Principal Office Address: 1001 USA W. 11th, MISHAWAKA, IN, 46544, Jurisdiction of Formation: Indiana 100slered Agent Information Type: Business Business Status: Active Inactive Date: Expiration Date: Perpetual Business Entity Report Due 05/31/2025 Date: Years Due: Name: NATIONAL CONSTRUCTION ENTERPRISES INC. Address: 1001 W.11th, Mishawaka, IN, 46544 - 0000, USA AIA Document A305 Contractor's Qualification Statement 1986 EDITION This form is approved and recommended by the American Institute of Architects (AIA) and The Associated General Contractors of America (AGC) for use in evaluating the qualifications of contractors. No endorsement of the submitting party or verification of the information is made by the AIA or AGC. The Undersigned certifies under oath that the information provided herein is true and sufficiently complete so as not to be misleading. SUBMITTED To: City of South Bend, IN Board of Public Works ADDRESS: 227 Jefferson Blvd South Bend, IN SUBMITTED BY: NAME: Gibson -Lewis, LLC ADDRESS: 1001 W. 11th Street Mishawaka, IN 46544 PRINCIPAL OFFICE: NAME OF PROJECT: Beacon Health Parking Lot TYPE OF WORK: X General Construction Plumbing Other (Please specify) Corporation 13 Partnership El Individual Il Joint Venture Other El Limited Liability Company HVAC Electrical Cv ri t 1964, 1969, 01986 b The American Institute of Architects, 1735 Now York Avenue, N.W. %shin mi, epr uction n t tc matcria ierein or su antial quotation of is provisions w 1 out written pernusston o the AIA violates the copyright laws of the United States and will be subject to legal prosecution. AIA DOCUMENT A305 - CONTRACTOR'S QUALIFICATION STATEMENT • 1986 EDITION • AIAV - 01986 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W. WASHINGTON. D.C. 20006 A305-1986 1 k31U5U11-LUW15, LLU 1. ORGANIZATION 1.1 How many years has your organization been in business as a Contractor? 56 years 1.2 How many years has your organization been in business under its present business name? 28 years 1.2.1 Under what other former names has your organization operated? Gibson -Lewis, Inc. was incorporated into LLC in 1995 1.3 If your organization is a corporation, answer the following: 1.3. l Date of incorporation: 1.3.2 State of incorporation: 1.3.3 President's name: 1.3.4 Vice-president's name: 1.3.5 Secretary's name: 1.3.6 Treasurer's name: 1.4 If your organization is a partnership, answer the following: 1.4.1 Date of organization: 1 A.2 Type of partnership: 1.4.3 Name(s) of general partner(s): 1.5 If your organization is individually owned, answer the following: 1.5.1 Date of organization: 1.52 Name of owner: AIA DOCUMENT A305 • CONTRACTOR'S QUALIFICATION STATEMENT • 1986 FOITION - AIAO -01986 A3�5.1988 2 THE AMERICAN 1NSTITU'rE OF ARCHrrECTS, 1735 Nr.W YORK AVENUE, N.W. WA UNGTON, D.C.2000G Gibson -Lewis, LLC 1.6 If the fornt of your organization is other than those listed above, describe it and name the principals; Robert A. Lingenfelter James E. Nagle Nicholas A. Gurbick Elizabeth Biddle 2. UGENSING - President - Vice President - Vice President - Assistant Secretary 2.1 List jurisdictions and trade categories In which your organization is legally qualified to do business, and indicate registration or Iloense numbers, if applicable: Indiana and Michigan 2.2 List jurisdictions in which your organization's partnership or trade name is riled. 3. EXPERIENCE 3.1 List the categories of work that your organization normally porforms with its own forces. Metal Framing, Drywall, Drywall Finishing, Insulation, Plastering, Acoustical Ceilings, Firestopping, Concrete, Carpentry, Painting, and Selective Demolition 3,2 Clainis and Suits. (i r itte-answer to any of the questions below is ycs, please uUach details.) 3.2.) Has your organization ever failed to complete any work awarded to it? No 3.2.2 Are there any judgments, elaints, arbitration proceedings or suits pending or outstanding against your organization or It's officers? No 3.2.3 Has your organization filed any law suits or requested arbitration with regard to ens rue Ion conintc s t n file I qsi"live you sI No AIA DOCUMENT A305 -CONTRACT)OR'SQUALIFICATION 91WITMENT • 198611DIIION •A[A0 •01986 TIIK AM11RICAN 1NS'TITUTE Or ARCHITECTS, 1735 NLW YORK AVr..NUK, N.W. WASIIINGTON,D.C, 20006 A305.1986 3 Gibson -Lewis, LLC 3.3 Within the last five years, has any officer or principal of your organization ever been an officer or Principal of another organization when it failed to complete a construction contract? (If the answer is yes, please attach details.) No 3,4 On a separate sheet, list major construction projects your organization has in progress, giving the name of project, owner, architect, contract amount, percent complete and scheduled completion date. Please see attached 3A.1 State total worth of work in progress and under contract: 3.5 On a separate sheet, list the major projects your organization has completed in the past five years, giving the name of project, owner, architect, contract amount, date of completion and percentage of the cost of work performed with your own forces. Please see attached 3.5.1 State average annual amount of construction work performed in the past five years: 3.6 List the construction experience and present commitments of the key individuals of your organization. Please see attached 4. REFERENCES 4.1 Trade References: Foundation Building Materials 5203 Division Avenue Grand Rapids, MI 49548 L & W Supply 1401 S Main Street South Bend, IN 46613 Big C Lumber Company 50860 Princess Way Granger, IN 46530 4.2 Bank References: Wheaton Bank & Trust 211 South Wheaton Avenue Wheaton, IL 60187 Office: 630-456-7853 Fax: 630-690-7715 4.3 Surety: Phone: 616-534-4904 Fax: 616-724-2651 Phone: 574-289-5566 Fax: 574-289-5569 Phone: 574-277-4670 Fax: 574-271-3834 AIA DOCUMENT A305 - CONTRACTOR'S QUALIFICATION STATEMENT - 1986 EDITION - AIAO - V1986 TI IL' AMERICAN INSTITUTE OF ARC111TECI S, 1735 NEW YORK AVENUE, N.W. WASI IINO'rON, D.C. 20006 A305-1986 4 ubson-Lewis, LLC; 4.3.1 Name of bonding company: The Continental Insurance Company CNA Plaza - Chicago, IL 60603 4.3.2 Name and address of agent: Marsh USA, Inc. Daniel Machado One Towne Square, STE 1100 Southfield, MI 48076 5. FINANCING 5.1 Financial Statement, 5.1.1 Attach a financial statement, preferably audited, including your organization's latest balance sheet and income statement showing the following items: Current Assets (e.g., cash, joint venture accounts, accounts receivable, notes receivable, accrued income, deposits, materials, inventory and prepaid expenses); Please see attached Net Fixed Assets; Other Assets; Current Liabilities (e.g., accounts payable, notes payable, accrued expenses, provision for income taxes, advances, accrued salaries and accrued payroll taxes); Other Liabilities (e.g., capital, capital stock, authorized and outstanding shares par values, earned surplus and retained earnings). 5.1.2 Name and address of firm preparing attached financial statement, and date thereof: Crowe LLP - 330 E. Jefferson Blvd, South Bend, IN 46601 5.1.3 Is the attached financial statement for the identical organization named on page one? Yes 5.1.4 If not, explain the relationship and financial responsibility of the organization whose financial statement is provided (e.g., parent -subsidiary). 5.2 Will the organization whose financial statement is attached act as guarantor of the contract for Construction ? yes AIA DOCUMENT A305 - CONTRACTOR'S QUALIFICATION STATEMENT - 1986 EDITION - AIA® - 01986 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W. WASHINGTON, D.C. 20006 A305-1986 5 Officer Robert A. Lingenfelter James E. Nagle Nicholas A. Gurbick Elizabeth Biddle KEY PERSONNEL # of Years Title Experience President 34 Years Vice President 38 Years Vice President 11 Years Assistant Secretary 23 Years Gibson -Lewis, LLC 6. SIGNATURE 6.1 Dated at Mishawaka, IN this Name of 019;,jizKjg1- Gi�§h-Lewis, LLC By: Title:' Nick Gurick, Vine President 6.2 1 Oth day of December, 202z Nick Gurbick being duly sworn deposes and says that the information provided herein is true and sufficiently complete as not to be misleading. Ifd and sworn he ' re me this 1 Oth day of December, 2024 Ju ' Hod. aniec My Commission UN )fires: 8/05/2031 JULI HODOWANIEC Notary Public - 5eal 5t Joseph CaUntY State nI fndiana Commission NU+nber NPD6yp284 MY Commission Fxpfres Aug 5, 203 t AIA DOCUMENT A305 - CONTRAc'rOR,s QUALIFICATION STATEMENT - 1986 EDITION - AIAV - 01986 A305.1986 6 THE AMERICAN INSTITUTE OF ARCHITECTS. 1735 NEW YORK AVENUE, N.W. WARIINGTON, D.C.20W6 INDIANA/KENTUCKY/OHIO REGIONAL COUNCIL OF CARPENTERS JOINT APPRENTICESHIP AND TRAINING FUND 1565 EAST 70TH COURT MERRILLVILLE, IN 46410 ADMINISTRATIVE OFFICE 711 Greenwood Springs Drive Greenwood, IN 46143 Phone:317-807-1112 Fax:317-807-1115 GRAYSON CAMPUS 574 Carpenters Way Grayson, KY 41143 Phone:606-929-1362 Fax:606-929-5319 INDIANAPOLIS CAMPUS 711 Greenwood Springs Drive Greenwood, IN 46143 Phone:317-807-1116 Fax:317-807-1131 LAFAYETTE CAMPUS 2953 South Creasy Lane Lafayette, IN 47905 Phone:765-447-5959 Fax:765-447-7676 LOUISVILLE CAMPUS 1245 Durrett Lane Louisville, KY 40213 Phone: 502-366-8668 Fax:502-366-8678 MERRILLVILLE CAMPUS 1565 East 701h Court Merrillville, IN 46410 Phone:219-947-3348 Fax:219-947-1889 MUNCIE CAMPUS 5400 East Centennial Avenue Muncie, IN 47303 Phone:765-288-9015 Fax:765-288-9298 NEWBURGH CAMPUS 5400 Covert Court Newburgh, IN 47630 Phone:812-853-9312 Fax:812-853-9316 TERRE HAUTE CAMPUS 3099 S. Ch Street Terre Haute, IN 47805 Phone:812-466-7899 Fax:812-466-9840 WARSAW CAMPUS 1095 Mariners Drive Warsaw, IN 46582 Phone: 574-267-5264 Fax: 574-269-1464 November 29, 2024 Gibson Lewis, LLC 1001 W. I It" Street Mishawaka, IN 46544 To Whom It May Concern: Ne, u This letter is in response to verification needed by Gibson Lewis, LLC for work to be performed on the Beacon Health Parking Lot, owner City of South Bend, Indiana Board of Public Works. Gibson Lewis, LLC regularly employs a number of apprentices affiliated with our apprenticeship program and has done so for more than four years. We are registered with the United States Department of Labor, Bureau of Apprenticeship and Training and our registration number is IN010520001. Our program participates in the Building Trades Associate Degree Program with Ivy Tech Community College and has done so since 1996. There have been over 300 apprentices in the last 5 years that have completed the apprenticeship and advanced to Journeyman. Gibson Lewis, LLC is a bona fide contractor in good standing with the Indiana/Kentucky/Ohio Regional Council of Carpenters Joint Apprenticeship and Training fund and is eligible to employ apprentice carpenters in the future. I have enclosed a copy of our certificate from the United States Department of Labor. If I can be of further assistance, please do not hesitate to give me a call. Sincerely, SWA Chris Charters Area Training Coordinator IKORCCJATF — Merrillville, Lafayette & Warsaw Campuses CC/rlb d a O 0 0 N O 0 0 m rn a N N 0 00 m 9 m N (D Cn N E E-111,01vil t �• � zrot � 1ALI o n cn OI_ �` Uxr �m z <zz - �. m — C� I rr- r m F-- � F-zc A �oZ 5 y 0 , Z m zz-0 Z D � m � z z i m �+ X 71 INDIANA LAB ORERY TRAINING TR UST F UND David A. Frye Secretary -Treasurer Jerry J. Bolk Chris Brickey Ricky Henson, Jr. Ramon Mendoza, Jr. Brian Short P.O. Box 758 - Bedford, Indiana 47421 (812)279-9751 September 3, 2024 To Whom It May Concern: C, Sean Coakley, Director John P. Brown Chairman Kelly Abel Michael Ferrara Stan Meyer Nick Timmerman Jim Wiseman FAX: (812) 279-5545 Toll Free (800) 742-4086 This letter is to confirm that "Gibson -Lewis LLC is a signatory contractor in good standing with the Indiana Laborers' Training Trust Fund. The above mentioned company is a participant in the Joint Apprenticeship and Training Committee through this Union and has been an active participant in good standing for each of the past five plus consecutive years, and is currently eligible to use our apprentices on a project. Further, our organization's program is approved by the U.S. Veterans Administration to participate in the GI educational benefits program. A copy of our approval letters are attached along with the collective bargaining agreement stating the ratios of Journey workers to Apprentices; which is one (1) Apprentice for every five (5) Journey workers and thereafter may not employ more that (1) Apprentice for every (3) Journey workers. Sincerely, Sean Coakley, Director SC:dc www.indianalaborerstraining.org w o H 1 H R:J z o � H ir1 � a H [H!] UO i O J H cd A H .r-i a o En m _ o W u PCI a cc 0 0 LW FIR. !�[ y a STATE OF INDIANA DEPARTMENT OF VETERANS AFFAIRS STATE APPROVING AGENCY 402 WEST WASHINGTON STREET ROOM W-469 INDIANAPOLIS, INDIANA 46204-2738 Jeremy Brewer Apprenticeship Coordinator Indiana Laborers Training Trust Fund -Apprenticeship 439 Patton Hill Rd. Bedford, IN 47421 Dear Jeremy Brewer, Eric Holcomb, Governor James M. Brown, Director January 9, 2019 The Indiana State Approving Agency conducted a supervisory visit on 01/8/2019 at Indiana Laborers Training Trust Fund -Apprenticeship. The purpose of the visit was to provide training to the Certifying Officials and review enrollment certifications, record retention and reporting procedures. The organization demonstrated proper record maintenance and record maintenance and reporting procedures. During the visit, we discussed the importance of reporting hours on a monthly basis, good record keeping techniques, and how to report a leave of absence or completion via VA Form 22-1999b. We also updated the Certifying Officials via VA Form 22-8794, work processes, and wage scale. If you need any assistance or have any questions regarding this technical visit please contact me directly at tgriffm@dva.in.gov or (317) 232-3916. Thank you for the courtesy extended during my visit. The education and training opportunities that your organization continues to provide veterans and their dependents are appreciated. Sincerely, Taniqua Griffin Program Director 011,004 %,"" tiorq�q �� � y b V9 0 Phone (317)-234-6062 Toll Free (800)-400-4520 Fax (317)-234-8744 STATE OF INDIANA DEPARTMENT OF VETERANS AFFAIRS STATE APPROVING AGENCY 402 WEST WASHINGTON STREET ROOM W469 INDIANAPOLIS, INDIANA 46204-2738 Jeremy Brewer Apprenticeship Coordinator Indiana Laborers Training Trust Fund -Apprenticeship 439 Patton Hill Rd. Bedford, IN 47421 Dear Jeremy Brewer, Eric Holcomb, Governor James M. Brown, Director January 9, 2019 This will acknowledge receipt of your updated Wage Scale for the Construction Craft Laborer program offered by Indiana Laborers Training Trust Fund -Apprenticeship. The State Approving Agency has reviewed the document as listed below: Wage Scale: Construction Craft Laborer FACILITY CODE: 30004114 To the best of my knowledge Indiana Laborers Training Trust Fund -Apprenticeship does not utilize erroneous or misleading advertisement, either by actual statement, onussion, or intimation. It is understood by Indiana Laborers Training Trust Fund -Apprenticeship that they will maintain a complete record of all advertising utilized by or on behalf of the Indiana Laborers Training Trust Fund -Apprenticeship in regards to their training programs during the preceding 12 months. Indiana Laborers Training Trust Fund -Apprenticeship's advertising will be available for review by any and all future supervisory visits by the SAA, or the U.S. Department of Veteran Affairs. Please Review the entire packet for content and accuracy. Approval is granted pursuant to the provisions of Title 38, U.S. Code 3687, with an effective date of April 1, 2018. If you have any questions, please feel free to give me a call at 317-232-3916 or email me at tgriffin@dva.in.gov. Thank you for what you do for our Veterans, and have a great day! Sincerely, Taniqua Griffin Program Director State Approving Agency Cc: VARO/ELR `9 ry�In q�q �01,9 ��TFq,opaO �✓t� �NG� STATE OF INDIANA DEPARTMENT OF VETERANS AFFAIRS STATE APPROVING AGENCY 402 WEST WASHINGTON STREET ROOM W-469 INDIANAPOLIS, INDIANA 46204-2738 Jeremy Brewer Apprenticeship Coordinator Indiana Laborers Training Trust Fund -Apprenticeship 439 Patton ill Rd. Bedford, IN 47421 Dear Jeremy Brewer, Eric Holcomb, Governor James M. Brown, Director January 9, 2019 This will acknowledge receipt of your revised Work Processes for the Construction Craft Laborer program offered at Hoosier Energy, located in Bedford, Indiana. The State Approving Agency has reviewed the document as listed below: TRAINING PROGRAM LENGTH DOT C0DI{: Construction Craft Laborer FACILITY CODE: 30004114 4,000-7800 hours 47-2061.00 To the best of my knowledge Indiana Laborers Training Trust Fund -Apprenticeship does not utilize erroneous or misleading advertisement, either by actual statement, omission, or intimation. It is understood by Indiana Laborers Training Trust Fund -Apprenticeship that they will maintain a complete record of all advertising utilized by or on behalf of the company in regards to their training programs during the preceding 12 months. The company's advertising will be available for review by any and all future supervisory visits by the SAA, or the U.S. Department of Veteran Affairs. This approval is made pursuant to and under the provisions of Title 38, U. S. Code 3687, with an effective date of January 8, 2019. If you have any questions, please contact me at 317-232-3916. Sincerely, Taniqua Griffin Program Director State Approving Agency Cc: VARO/ELR 014 41P ✓�� �� Act <'/, 916Z 9c� Phone (317)-234-6062 Toll Free (800)-400-4520 Fax (317)-234-8744 Apprentice Status Report By Indenture Date Apprentices Indentured Between 1/1/2019 And 12/31/2023 Apprentice Program: IN2 Year Apprentice Status Apprentices Percentage 2019 2020 Active 26 2.84 % Adv. to Journeyman 96 10.47 % Deceased 9 01980/0 Graduated 110 12.00 % Inactive 11 1.20 % Journeyman 12 1.31 % Med. Susp, 1 0.11 % Reinstate 2 0.22 % Suspended 1 0.11 % Terminated 578 63.03 % Voluntary withdraw 71 7.74 Total Indentured 917 Active 32 4.95 % Adv. to Journeyman 72 11.15 % Deceased 2 0.31 % Graduated 59 9.13 % Journeyman 1 0.15 % Not Registered 1 0.15 % Reinstate 2 0.31 % Suspended 1 0.15 % Terminated 431 66.72 % Voluntary withdraw 45 6.97 Total Indentured 646 Printed: a nes ay, May 29, 2024 Page T=3 Apprentice Status Report By Indenture Date Apprentices Indentured Between 1/1/2019 And 12/31/2023 Apprentice Program: IN2 Year Apprentice Status Apprentices Percentage 2021 2022 Active % 13.07 % Active Duty 1 0.13 % Adv.-to Journeyman 68 9,07 % Deceased 2 0.27 % Graduated 65 &67 % Reinstate 4 0.53 % Suspended 2 0.27 % Terminated 467 62.27 % Voluntary withdraw 43 5.73 % Total Indentured 750 Active 341 35.56 % Adv. to Journeyman 70 7.30 % Deceased 5 032 %o Graduated 23 2.40 % Journeyman 1 0.10 % Med. Susp. 2 0.21 % Not Registered 1 0.10 % Reinstate 10 1.04 % Suspended 9 0.94 % Terminated 467 48.70 % Voluntary withdraw 301 3.13 TotalIndentured 959 Printed: Wednesday, May 29.2024 Page 2 of 3 Apprentice Status Report By Indenture Date Apprentices Indentured Between 1/l/2019 And 12/31/2023 Apprentice Program: IN2 Year Apprentice Status Apprentices Percentage 2023 1 0.10 % Active 597 57.90 % Active Duty 1 0.10 % Adv. to Joumeyman 35 3.39 % Deceased 2 0.19 % Graduated 1 0.10 % Journeyman 3 0.29 Med. Susp. 3 0.29 % Not Registered 4 0.39 % Reinstate 34 3.30 % Suspended 4 .0.39 % Terminated 325 31.52 % Voluntary wiithdraw 21 2.04 % Total Indentured 1031 Printed: Wednesday, May 29, 2024 Page 3 of 3 fwdNnitea tatrq Mrpartment f If'a460t Office of Apprentire-9bip Certificate of Regi5tration of Apprentirr,5bip Program FTI OF DC 91 Indianapolis, IN See program standards for occupations eyr'sfereo%as parf ol'112,c Va .16naj 3,oprenlrces-12rp 6 stern in accorolance wilij fie basic siano(arors of-apprenlrce.s�-f esfa� s erg fl:?-e 6ecrel= o� cr or March 09, 2009 ��'�N' `1 )ale IN070092065 Sri7�S 111� 4AV i •+L 7idmin�.+Iruiar, �J�rce o�f.�%pprrnircrs�ry Plasterers' & Cement Masons' Apprenticeship Coordinator Local Union #692 To Whom it May Concern: Phone: (219) 707-7767 Email: bkristoff@plcmlocal692.org September 5, 2024 This letter is to certify that Gibson -Lewis LLC. is and has been a signatory contractor with OPCMIA Local 692 and has participated in the Plasterers & Cement Masons Apprenticeship Training Program for many years. Gibson -Lewis LLC. is a valued Contractor in good standing with Local 692 and the JATC. All our apprentices are registered with the United States Department of Labor. I may be reached at (219) 707-7767 if additional information is needed. Further, our organization's program is approved by the U.S. Veterans Administration to participate in the GI Education Benefit Program. Thank you, Brian Kristoff Apprentice Coordinator Plasterers & Cement Masons 9200 Louisiana Street a Merrillville, Indiana 46410 'anite% tatr.55 �e�artmerrt of �r�� r 0 office of Apprentirt5bip (Certificate of 3&rgiaration of 2[pprtntirobip grogram PLASTERERS & CEMENT MASONS LOCAL 692 J.A.T.C. MERRILLVILLE) INDIANA FOR THE TRADE CLASSIFICATIONS: CEMENT MASON; PLASTERER JLepprsfereofds parf o� fie Q tonal f,nj�renflces�l�D c��Sfe122 J In accoro(ance wlf12 h e 4aslc sfdno�zro(S Of Qpp renflces_.o esfa4ft: ieo6� faze 6ecrefary o,f)-rodbor MAY 22, 1995 Revised: November 1, 2018 I N010950002 4A 41 7r/irr'rrr'slrulor•. � ��%r�-e of `.�lppren/ic�>.�I�il+ GIBSON-LEWIS, LLC CONTRACTORS 1001 West 11 th Street ♦ Mishawaka, IN 46544 ♦ P.O. Box 488 ♦ Mishawaka, IN 46546 (574) 259-8581 ♦ (574) 258-0932 FAX www.gibson-lewis.com Drug & Alcohol Free WorkPlace The Company is committed to the establishment and maintenance of a safe and efficient work environment for all employees free from the effects of alcohol, illegal drugs, and other controlled substances and prohibited items. Section 1. Polk The Company is committed to providing its employees with a workplace that is safe, productive and free of substance abuse. The company will take reasonable measures to insure that employee alcohol or drug use does not jeopardize the safety of other employees, does not impair their ability to operate efficiently and insures compliance with drug testing programs mandated by state or federal agencies. Section 2. Prohibitive Conduct — Drugs The use, manufacture, distribution, dispensation, sale or possession of illegal drugs at any time or place, whether on or off duty is strictly prohibited. Legal Drugs — The use of legal drugs (over the counter or prescription medication) in accordance with doctor's orders or manufacturer's recommendations, is not prohibited as long as your Supervisor is notified. Excessive use beyond that prescribed or recommended or abuse of such drugs, however, shall be considered use of illegal drugs under this policy. Section 3. Prohibitive Conduct — Alcohol The unauthorized use or possession of alcoholic beverages while at the workplace or performing company business, is prohibited. The term "work place" as used in this policy includes company premises, jobsites, worksites, parking areas and company vehicles. The use of alcohol off premises in any manner which results in intoxication or impairment on the job or which adversely affects attendance or job performance, is prohibited. Appearing for work or performing any -job duties or company business while intoxicated or impaired by alcohol is strictly prohibited. This may be an abbreviated version of the company's drug and alcohol free work place policy. Check with your supervisor or person providing the new hire orientation for further details. A NATIONAL CONSTRUCTION ENTERPRISES COMPANY - GIBSON -LEWIS LLC CONTRACTORS 1001 West 1 1" Street Mishawaka, IN 46544 P.O. Box 488 Mishawaka, IN 46546 't _� (574) 259-8581 (574) 258-0932 FAX To all lUPAT Members Gibson -Lewis Employees, In order to meet the expectations of the General Contractors, Construction Managers, and Building Owners, we at Gibson-Lcwis, LLC effective immediately, are implementing that we will be following the BCRC (Building and Construction Resource Centers) guidelines for drug testing. BCRC is an Alliance between the labor and the management representatives for Local union # 460, and now # 1118. Their goal is to assist employers with establishing and maintaining workplaces that are free from destructive effects caused when employees use drugs and/or abuse alcohol. What does this mean as a Gibson -Lewis Employee? Each and every employee with in the union should have received a letter in January from the BCRC (Building and Construction Resource Centers) along with a card and an I.D number. This is your ID card for identifying yourself as the person who received it from the BCRC. 1 will be attaching with this letter a copy of the letter sent to you back in January, along with the phone number of how to contact the BCRC. All Gibson -Lewis, LLC employees must have this drug testing procedure finalized by No I..ater then, April 17th, 2009. If not completed by this time, employees will be unable to come into work until the test has been completed. Where can I take this drug test? Any Med-Point clinic offers this drug test for the BCRC requirements. Check with nearest Med-point clinic to set-up an appointment. We at Gibson -Lewis, LLC want all of our employees to be safe everyday and be able to work in a safe environment. Each day, our employees, along with you make a difference to setting standards of being a safe company. By implementing this program, we are not only taking this next step to being an elite company, we are taking a step towards an injury free workplace. Please contact me with any questions, at 574-780-3468. Respectfully, Brian Shumaker Safety Director �Y:\.: Y■N aA MA nY..N CYww Building & Construction Resource Center, Inc. Phone: (219) 764-9500 • Fax: (219) 764-9505 TO Free: (877) 988-5400 6050 Southport Rd., Ste. B • Portage, IN 46368 www.BCRCNET.cojm Tish Roach Executive Director 'Perspectives (800) 456-6327 www.perspectivesltd.com Your Employee Assistance Program (EAP) INDEX PAGE Introduction . . . . . . . . . . . . . . . . . . 1 the Policy . . . . . . . . . . . . . . . . . . . 2 Definitions . . . . . . . . . . . . . . . . . . . 4 Drug Testing . . , . . . . . . . . . . . . , . . 20 Drug Group . . . . . . . . .. . . . . . . . 22 Alcohol Testing . . . . . . . . . . . . . . . . 23 Payment for Testing . . . . . . . . . . . . . . 24 Initial Testing (Pre -Employment) . . . . . . . 27 Random Testing . . . . . . . . . . . . . . . . 27 Vacation Status .... . . . . . . . ... .. . 28 Owner Requested On -Site Random Testing. .30 Probable Cause Testing . . . . . . . . . . . . 31 Post-Accident/Incident Testing . . . . . . , . 32 Rapid Test Prohibited . . . . . . . . . . . . . 34 "Emergency" Work Assignments . . . . . . . 34 Card System . . . .. . . . . . . . . . . . . . 36 Status Confirmation . . . . . . . . . . . . . . 36 Reporting of Test Results . . . . . . . . . . . 37 Insufficient Specimen .38 Dilute Specimen . . . . . . . . . . . . . . . . 38 Adulterated, Substituted, and/or Out -of -Temperature Specimen . . . . . . . 39 Consequences for a Non -Negative or Positive Test . . . . . . . . . . . . . . . 40 Additional Consequences for Multiple Non -Compliant Events . . . . . . . . . . . 42 INDIA PACE Observed Return To Duty Testing . . . . . . . 44 Observed Follow -Up Testing . . . . . . . . . 45 Disputed Positive Results . . . . . . . . . . . 46 Appeals and Protections/just Cause . . . . . . 47 Illinois — "Drug Free Workplace Act" — 30 ILLS 580 . . .. .. .... . . . . . . 49 Illinois — "Substance Abuse Prevention on Public Works Projects Act"— 820 ILCS 265 .... 50 Illinois — "Cannabis Regulation and Tax Act" — 410 ILCS 705 .... . . .. . . . . . . . . 51 Indiana — Drug Testing for Public Works — IND. Code 4-13-18 . . . . . . . . . . . . . 51 Letters of Notice for Random Testing . . . . .53 Attachment A — General Trades . . . . . . . . 53 Attachment B — Non -Bargaining . . . . , . . 54 Attachment C — Pipe Fitters Local #597 . . .55 Attachment D — BCRC Authorization to Release and Disclose Information & Documents . . . 56 Attachment E — BCRC Application Form . . . 59 — BCRC Permission Form to Obtain BCRC Status .. ... 60 — BCRC Testing Information and Instruction Sheet . . . . . 61 Attachment F — BCRC On -Site Substance Abuse Testing Addendum . .. . . . . . . 62 Attachment G — BCRC Drug/Alcohol Testing Notification . . . . . . . . . . . . . 63 BUILDING AND CONSTRUCTION RESOURCE CENTER, INC. INTRODUCTION The Labor and Management representatives of the Building and Construction Industry for Northwest Indiana have formed an alliance to address the problems caused by drug and alcohol abuse. Management and Labor together have created the Building and Construction Resource Center, Inc. (hereafter "BCRC"), an independent not -for -profit corporation that offers a wide range of services to Employees in the unionized construction industry, which includes Employers and Labor Union organizations. It is BCRC's goal to assist Employers in establishing and maintaining workplaces that are free of the destructive effects caused when Employees use or abuse drugs and/or alcohol. BCRC's activities are not intended to interfere with normal practices of the Labor Unions or Management. BCRC recognizes its responsibility to communicate with and educate Employers and Employees in the unionized construction industry concerning this policy, as well as the harmful effects of drugs and alcohol in our society and in the workplace. BCRC also recognizes the need to provide a program of assistance to those persons for whom drugs or alcohol may be causing problems. Our Employee Assistance Program (EAP) provides support, counseling and resources for life issues that can take a toll on your emotional well-being or take time away from things you value the most, like work and family. Finally, while not wishing to violate the rights or invade the privacy of any Employee, BCRC's drug testing program will seek to identify those Employees who are unable or unwilling to conform to BCRC's program. This program has been established in accordance with the Drug and Alcohol Testing Industry Association (DATIA), the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Federal Department of Transportation Guidelines for specimen collection, laboratory analysis and review, and standards of integrity and confidentiality. 1 THE POLICY Persons who use or abuse drugs and/or alcohol, on or off their jobs, are likely to be less productive, to be less reliable, to be more frequently absent and to have other work -related problems that can cause increased costs, delays, accidents and injuries. These Employees can also risk the health, safety and well-being of other workers on the job. The unionized construction industry can control and reduce this problem through recognition of the problem, development of a comprehensive policy and program of education and information, promotion of an Employee Assistance Program (EAP) and implementation of fair and respectful drug testing that conforms to the Drug and Alcohol Testing Industry Association (DATIA), the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Federal Department of Transportation Guidelines for specimen collection and analysis. All of this is to be done with the utmost confidentiality and respect for the individual. All Employers (as defined herein) hereby adopt the following policy: No Employee may use, possess, distribute, deliver, or be under the influence of a drug, or use or be under the influence of alcohol, while performing any work for the Employer. In order to enhance substance abuse awareness among all Employers and Employees, educational seminars and training programs will be offered. The educational seminars will be directed toward education in regards to the seriousness of the nationwide drug and alcohol abuse problem and how the use of drugs and alcohol negatively impacts safety, productivity, and the competitive ability of the American workforce. Supervisors will be trained to identify Employees in potentially difficult situations and to recognize signs of impairment, as well as the Supervisors'responsibility to document, intervene and follow-up with the troubled individual. These sessions will be offered as ongoing training programs. BCRC, encourages all Employees troubled by their own or a family member's drug or alcohol abuse to seek professional care and treatment. Early recognition and treatment of alcohol and drug abuse provides the greatest opportunity for successful recovery. BCRC provides an Employee Assistance Program (EAP) for all Employees and their families who need professional guidance in assessing their substance abuse or alcohol -related problem and choosing an appropriate course of treatment. Current Employees will be referred to an EAP Representative as a result of a non -negative (positive) drug or alcohol test, a non -compliant event or upon an individual's own request. In either case, the content of the discussion with the EAP will be protected and confidential to the extent allowed by law. A Participant's use of and communications with the EAP are confidential and information regarding such confidential matters will not be released to BCRC or any of its subscribing organizations or participants without written release from the participant in accordance with the law. Employees who use the EAP as a consequence of a non -negative (positive) drug or alcohol test, or a non -compliant event, will be subject to the conditions established in the drug testing portion of this policy and as outlined by the EAP Counselor. The EAP staff has knowledge of the level and types of benefits available to BCRC Employees. Employees can access the services of the EAP through a hotline that is staffed twenty-four (24) hours a day, seven (7) days a week, throughout the entire year. Employees calling the EAP hotline are put in touch with a counselor who will conduct a professional assessment and who may meet with them to further assess the nature of the problem in order to provide a referral to the best and most appropriate level of care. The EAP is staffed by certified and Masters -level credentialed human services professionals who are sensitive to 3 the needs of the individual. Individuals who take the initiative to contact the EAP for assistance do so with the assurance that their calls will be treated respectfully and confidentially. The direct services provided by the EAP are sponsored by BCRC. In compliance with Public Law 100-690 (The Drug -Free Workplace Act), which applies only to Employers who have federal grants or federal contracts of more than $100,000, an Employee who is convicted of a workplace drug or alcohol violation and who is employed by a BCRC affiliated Employer must report this information to his/her immediate supervisor no later than five (5) days after such conviction. The Supervisor must report this information immediately to the Employer's Program Administrator. DEFINITIONS ■ Addendums (i.e., Attachment F) may be approved by the Board of Directors on an as -needed basis. Adulterated Specimen means a specimen that has been altered, as evidenced by test results showing either a substance that is not a normal constituent for that type of specimen or showing an abnormal concentration of an endogenous substance. Air Blank means, in evidential breath testing devices (EBTs) using gas chromatography technology, a reading of the device's internal standard. In all other EBTs, a reading of ambient air containing no alcohol. • Alcohol means the intoxicating agent in beverage alcohol, ethyl alcohol, or other low molecular weight alcohols including methyl and isopropyl alcohol. • Alcohol Concentration (or contents means the alcohol in a volume of breath expressed in terms of grams of alcohol per 210 liters of breath as indicated by an evidential breath test under this policy (BrAC). Alcohol Confirmation Test means a subsequent test using an EBT, following a screening test with a result of 0.02 or greater, which provides quantitative data about the alcohol concentration. Alcohol Screening Device (ASD) a breath or saliva device, other than an EBT, that is approved by the National Highway Traffic Safety Administration (NHTSA) and appears on the Office of Drug and Alcohol Policy and Compliance (ODAPC) web page for "Approved Screening Devices to Measure Alcohol in Bodily Fluids" because it conforms to the model specifications from NHTSA. ■ Alcohol Screening Test means an analytic procedure to determine whether an employee may have a prohibited concentration of alcohol in a breath specimen. • Alcohol Testing Site a place selected by the Employer where employees present themselves for the purpose of providing breath or saliva for an alcohol test. • Alcohol_Use means the drinking or swallowing of any beverage, liquid mixture or preparation (including any medication), containing alcohol. ■ Aliquot means a fractional part of a specimen used for testing. It is taken as a sample representing the whole specimen. • Applicant means a person, Independent Contractor, or Employer, or person working for an Independent Contractor, or Employer who applies to become an Employee of a BCRC Contractor/Employer Participant, and includes a person who has received a job offer made contingent on the person passing a drug test. 5 • Archived Status means the status of a person who has been inactive, deactivated, working outside of the geographic area covered by BCRC or otherwise taken out of the BCRC. random pool. • Authorized Test means a drug and/or alcohol test performed in accordance with the provisions of this Policy and at the request (or direction) of BCRC. BCRC means Building and Construction Resource Center, Inc., which is a not -for -profit corporation formed by labor and management representatives of the building and construction industry for Indiana & Illinois, for the purpose of addressing problems of drugs and alcohol in the workplace. BCRC Policv means all of the policies, procedures, and other matters set forth in this document (i.e., the BCRC Drug & Alcohol Policy) and all amendments and addenda to this document. • Breath Alcohol Technician (BAT) is a person who instructs and assists employees in the alcohol testing process and operates an Evidential Breath Testing device (EBT). Canceled Test means a drug or alcohol test that has a problem identified that cannot be or has not been corrected. A canceled test is neither a positive nor a negative test. An Employer is not permitted to take adverse job action based on a canceled test. Card Manager is the individual designated by each Employer who has the authority to access data information that will confirm the status of Employees by electronic mail. C01 • CL or Clear means that an Employee is "cleared", available for work, and currently compliant with this Policy when used with respect to the BCRC status of an Employee. Chain of Custody the procedure used to document the handling of the urine specimen from the time the employee gives the specimen to the collector until the specimen is destroyed. this procedure uses the Federal Drug Testing Custody and Control Form (CCF) as approved by the Office of Management and Budget. • Collection Container means a container into which the Employee urinates to provide the specimen for a drug test. Collection Site means a place designated by BCRC where individuals present themselves for the purpose of providing a specimen to be analyzed for the presence of controlled substances or for purposes of providing a breath sample to be analyzed for alcohol concentration. Collector means a person who instructs and assists Employees at a collection site, who receives and makes an initial inspection of the specimen provided by those employees, and who initiates and completes necessary forms. Company means an Employer/Contractor who is a member of BCRC. • Confirmation (or confirmatory) DrµgTcst a second analytical procedure performed on a different aliquot of the original specimen to identify and quantify the presence of a specific drug or drug metabolite. 7 • Canfirmationlnr_cynfumatory} ValidityTe, 5 a second test performed on a different aliquot of the original urine specimen to further support a validity test result. • Confirmed DrugTests a confirmation test result received by an MRO from a laboratory. ■ Confirmatory Test a) For alcohol testing, a confirmatory test is a second test following a screening test with a result of 0.02 or greater, conducted 15-30 minutes later, that provides quantitative data of alcohol concentration. this test is conducted on an Evidential Breath Testing Device (EBT). b) For controlled substances testing, a confirmatory test is a second analytical procedure on the same specimen to identify the quantitation and presence of a specific drug or metabolite. This confirmatory test is independent of the initial test and uses a different technique and chemical principle from that of the screening test in order to ensure reliability and accuracy. Gas Chromatography/Mass Spectrometry (GC/MS) is the only authorized confirmation method for cocaine, marijuana, synthetic opiates, opioids, amphetamines and phencyclidine. • Contractor Participant means an Employer who is a contributing member of BCRC. Controlled Substance means marijuana (THC), cocaine, synthetic opiates, opioids, oxycodones, MDA-analogues, phencyclidine (PCP), amphetamines (including methamphetamines), methaqualone, barbiturates, benzodiazepine, propoxyphene, methadone, 6-acetymorphine and ecstasy. I)esignated Employer Representative (DER an Employee authorized by the Employer to take immediate action(s) to remove Employees from safety -sensitive duties or cause Employees to be removed from these covered duties and to make required decisions in the testing and evaluation processes. The DER also receives test results and other communications for the Employer consistent with the requirements of this policy. Service agents cannot act as DERs. • Dilute Specimen means a specimen with creatinine and specific gravity values that are not consistent with medical expectations for human urine. DOT these terms encompass all DOT agencies, including, but not limited to, the Federal Aviation Administration (FAA), the Federal Railroad Administration (FRA), the Federal Motor Carrier Safety Administration (FMCSA), the Federal Transit Administration (FTA), the National Highway Traffic Safety Administration (NHTSA), the Pipeline and Hazardous Materials Safety Administration (PHMSA), and the Office of the Secretary (OST). For purposes of this part, the United States Coast Guard (USCG) in the Department of Homeland Security is considered to be a DOT agency for drug testing purposes only since the USCG regulation does not incorporate Part 40 for its alcohol testing program. these terms include any designee of a DOT agency. Drugs mean the substances for which tests are required under this policy and include marijuana (THC), cocaine, amphetamines (including methamphetamines), methaqualone, phencyclidine (PCP), opioids, synthetic opiates, oxycodones, MDA-analogues, barbiturates, benzodiazepine, propoxyphene, methadone, 6-acetymorphine and ecstasy. �61 DruVjest means a test conducted for controlled substances. • Employee means an Employee of a Company, or of a Contractor/Employer Participant, who is a member of BCRC. Employee Assistance Pro am EAP Counselor means a Masters -level professional with an education in psychology, social work, counseling, etc. with knowledge of and clinical experience in diagnosis and treatment of alcohol and controlled substance related disorders. the EAP will assess and make recommendations concerning education, treatment, Observed Follow -Up Testing and aftercare. • Em-°lMr means a Company, or a Contractor/Employer Participant, who is a member of BCRC. Evidential Breath Testing Device EBT) means a device approved by NHTSA for the evidential testing of breath at the .02 and .04 alcohol concentrations, placed on NHTSAs Conforming Products List (CPL) for "Evidential Breath Measurement Devices" and identified on the CPL as conforming with the model specifications available from NHTSA's Traffic Safety Program. First Occurrence. Clause means if an Employee does not report for a random test, and it is the first time the Employee has failed to report, the'Ihird Party Administrator (TPA or BCRC) may allow the Employee to take the test without reporting to the EAP for further review. Employees may utilize this clause only one time. 'Gas Chxomatography/Mass Spectrometry Confirmation (GC/MS) is a state-of-the-art drug testing technology, providing a fingerprint of the detected drug. 10 HHS means the Department of Health and Human Services or any designee of the Secretary, Department of Health and Human Services. HHS--AvoLoved Laboratory any US. laboratory certified by HHS under the National Laboratory Certification Program as meeting the minimum standards of Subpart C of the HHS Mandatory Guidelines for Federal Workplace Drug Testing Programs; or, in the case of foreign laboratories, a laboratory approved for participation by DOT under this part. Initial Test (for drugs) means an immunoassay screen to eliminate negative urine specimens from further consideration. Initial 3 alidi Test means the first test used to determine if a specimen is adulterated, diluted or substituted. Znrr id Dru Test the result reported by an HHS certified laboratory in accordance with the criteria established by HHS Mandatory Guidelines when a positive, negative, adulterated or substituted result cannot be established for a specific drug or specimen validity test. • Laboratory any U.S. laboratory certified by HHS under the National Laboratory Certification Program as meeting the minimum standards of Subpart C of the HHS Mandatory Guidelines for Federal Workplace Drug resting Programs; or, in the case of foreign laboratories, a laboratory approved for participation by DOT under this part. 11 Licensed Medical Practitioner means a person who is licensed, certified, and/or registered, in accordance with applicable Federal, State, Local, or Foreign laws and regulations to prescribe controlled substances and other drugs. Medical Review Officer (MRO) means a Licensed Physician, registered with the American Association of Medical Review Officers (www.aamroxom), responsible for receiving laboratory results generated by B CRC's drug testing program who has knowledge of substance abuse disorders and who has appropriate medical training to interpret and evaluate an individual's confirmed positive test result together with his/her medical history and any other relevant biomedical information. N/A or Not Available means that an Employee is not available for work and is not currently compliant with this Policy when used with respect to the BCRC status of an Employee. (NOTE: An Employee can be N/A for several reasons, which may or may not include failing a drug or alcohol test). New Employee/Applicant means a person who has not been previously tested by BCRC and includes a person referred for pre -employment testing. Non -Compliant Event means any of the following: (a) a Positive Test for alcohol or drugs (which shall also include any Positive Tests that occur during any retesting), (b) an -Insufficient Specimen if an appropriate medical professional determines that there is no legitimate medical reason for the Insufficient Specimen, (c) a negative Dilute Specimen if the Employee fails to provide a second (2nd) testing sample within the applicable time period specified in this BCRC Policy 12 or a second (2nd) testing sample that is also a negative Dilute Specimen [provided, however, that a second (2nd) negative Dilute Specimen shall not constitute a Non -Compliant Event if. (1) the MRO determines that there is a valid medical reason for the second (2nd) Dilute Specimen, or (2) such treatment is prohibited by applicable law], (d) an Adulterated Specimen, (e) a Substituted Specimen, (f) an Out -of -Temperature Specimen, (g) any acts by an Employee that compromise the testing protocol (i.e., washes his/her hands, flushes the toilet, etc.) prior to being given direction from the collection professional, (h) a Refusal To Submit (to an alcohol or controlled substances test), (i) a failure to submit to Post-Accident/Incident Testing (which shall include a failure to test resulting from the Employee leaving the jobsite prior to such Post-Accident/Incident Testing), and 0) any other act or omission by an Employee that BCRC determines, in BCRC's sole discretion, to constitute a substantial or willful non-compliance with the policies and/or procedures set forth in this Policy. A Non -Compliant Event is also commonly referred to as a "strike." • Non -Negative means a urine specimen that is reported as an Adulterated Specimen, a Substituted Specimen, a Positive Test [for drug(s) or drug metabolite(s)], a Non -Compliant Event and/or invalid. • Observed Follow-[]Uv T estinshall be required, based on an EAP evaluation for a Non -Negative or Positive Test result, missed random, incomplete test/walk outs and as provided in this BCRC Policy. All Follow -Up Testing will be administered by the TPA (BCRC) and must be observed. • Observed Return To Duty Test or Observed RTD Test is an observed test required by this BCRC Policy that 13 must be taken before an Employee can be returned to "clear" status. Such test is scheduled by the counselor at such time as the counselor deems appropriate after the EAP evaluation has been completed. This BCRC Policy requires such test following a Non -Negative test, missed random, walkout, Refuse to Submit as described in the BCRC Policy, or other Non -Compliant Event. If the test is not taken as directed by the EAP, the Employee will be required to return to the EAP. • Out-of-Temi2crotureSpecirneii means a specimen that is below 90°F or above 100°F at the time the specimen is obtained at the collection site. • Owner means a business or other entity (or individual) that hires a "Contractor Participant" to perform work at their facility, office, and/or property. Owner Requested job -Site Random Testing means a Northwest Indiana Business Roundtable Owner, which has been approved by the Board of Directors, and may require a random drug test be done at their facility. The Employee will test within one hour of notification of the random test. The test may be performed at the Owner's facility no more than monthly provided there is an approved BCRC Collection Site at the facility. • Positive Test (alcohols occurs when an Employee's confirmatory test result reads 0.02 BrAC or higher. • Positive Test (dru) occurs when an HHS-certified laboratory reports a drug test as positive because a specimen contains a drug or drug metabolite equal to or greater than the cutoff concentrations. • Post-Accident/Incident Testing means drug and alcohol tests requested by an Employer following the occurrence of an accident and/or incident. 14 _Probable Cause Testing maybe required when a Supervisor observes and documents unusual behavior. Program Administrator means the individual who has administrative responsibilities for overseeing the drug and alcohol testing program for an Employer. the Program Administrator may serve as an Employer's DER. Pro a means all Employer -owned and/or leased property, including but not limited to owned and/or leased buildings and other real estate, parking lots and vehicles located on parking lots, and Employer -owned and/or leased vehicles, lockers, tools, equipment and desks. Random Selection means a scientifically valid method for selection of Employees to be tested that result in an equal probability that any Employee from a group of Employees subject to the selection mechanism will be selected, and does not give an Employer discretion to waive the selection of any Employee under the mechanism. ■ Refuse To Submit (to an alcohol or controlled sUb tanC test Means that an Employee: 1. Fails(ed) to appear for any test (except a pre -employment test) within a reasonable time, as determined by the BCRC Policy, after being directed to do so by the BCRC Policy; 2. Fails(ed) to remain at the testing site until the testing process is complete (a walk out); 15 3. Fails(ed) to provide a urine specimen for any drug test required by this BCRC Policy; 4. In the case of a directly observed or monitored collection in a drug test, fails to permit the observation or monitoring of the Employee's provision of a specimen; 5. Fails(ed) to provide a sufficient amount of urine when directed, and it has been determined, through a required medical evaluation, that there was no acceptable medical explanation for the failure; 6. Fails(ed) or declines to take a second test the Employer or collector has directed the Employee to take; 7. Fails(ed) to undergo a medical examination or evaluation, as directed by the MRO as part of the verification process, or as directed by the policy. In the case of a pre -employment drug test, the Employee is deemed to have refused to test on this basis only if the pre -employment test is conducted following a contingent offer of employment; 8. Fails(ed) to cooperate with any part of the testing process (e.g., refuse to empty pockets when so directed by the collector, behaves in a confrontational way that disrupts the collection process, provides incorrect or inaccurate information to the collection site or on necessary forms, or fails to complete all documents); 9. Provides a second (2nd) specimen that is dilute. Reinstatement Testis the test allowed by BCRC, which must be consistent with the Policy, to reactivate an Employee who has been on "Vacation" or "Archived 16 Status" for twelve (12) months or more and has not tested under the BCRC Policy in the past twelve (12) months. Rejected ForTesting the result reported by an HAS -certified laboratory when no tests are performed for a specimen because of a fatal flaw or a correctable flaw that is not corrected. Reporting Em to ee is an Employee who reports a work -related injury or illness that was caused by and/ or relates to the accident and/or incident for which the post-accident/incident drug or alcohol testing is requested by the Employer. Safe Site means a URL beginning with "https"which is a secure site for data transmission. SAMHSA means Substance Abuse and Metal Health Services Administration is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. Screening Test (oar initial test): In drug testing, a test to eliminate "negative" urine specimens from further analysis or to identify a specimen that requires additional testing for the presence of drugs. In alcohol testing, an analytical procedure to determine whether an employee may have a prohibited concentration of alcohol in a breath specimen. 17 • S greening Test Technician (STT means a person who instructs and assists employees in the alcohol testing process and operates an Alcohol Screening Device (ASD). • Shipping Container means a container that is used for transporting and protecting urine specimen bottles and associated documents from the collection site to the laboratory. 'Specimen means a sample of urine, used for analysis and/or diagnosis. For the purpose of this policy; specimen is defined as urine. Specimen Bottle means the bottle that, after being sealed and labeled according to the procedures in this policy, is used to hold the urine specimen during transportation to the laboratory. • Split means a part of the urine specimen that is sent to a first laboratory and retained unopened, and which is transported to a second laboratory in the event that the Employee requests that it be tested following a verified positive test of the primary specimen or a verified adulterated or substituted test result. Substituted Specimen means a specimen with creatinine and specific gravity values that are so diminished that they are not consistent with human urine. • 7estixig Levels means levels at or above when a specimen is determined to be positive, and below when a specimen is determined to be negative. Third 12—aM Administrator TPA means an entity that provides or coordinates one or more drug and/or alcohol testing services to Employers. A TPA typically provides or coordinates the provision of a number of such services and performs administrative tasks concerning the operation of drug and alcohol testing programs for Employers.'fhis term includes, but is not limited to, groups of Employers who join together to administer, as a single entity, the drug and alcohol testing programs of its Employees (e.g., having a combined random testing pool). • Traveler means a craft person who: (a) is coming to work in the geographic area covered by BCRC, and (b) is a member of a local union whose jurisdiction is outside of the geographic area covered by BCRC. Unauthorized Test means a drug and/or alcohol test that is: (a) not performed in accordance with the provisions of this Policy, and/or (b) not performed at the request (or direction) of BCRC. Such tests include retests initiated by an Employer and/or an Employee that are not performed at the request (or direction) of BCRC. • Union means a Labor Organization that represents Employee(s) wlio are employed by a Company, or of a Contractor/Employer participant, who is a member of Building and Construction Resource Center, Inc. Vacation Status means the status of an Employee who is temporarily removed from the BCRC random pool while on vacation or a non -work related absence. • Verified Test means a drug test result or validity testing result from a HUIS-certified laboratory that has undergone review and final determination by the MRO. 19